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New Mexico rates for HCPCS 0295U

Oncology (breast ductal carcinoma in situ), protein expression profiling by immunohistochemistry of 7 proteins (COX2, FOXA1, HER2, Ki-67, p16, PR, SIAH2), with 4 clinicopathologic factors (size, age, margin status, palpability), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm reported as a recurrence risk score

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $2,344.23 / $3,630.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.31 / $4,466.84 / $4,897.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,511.38 / $8,511.38 / $8,511.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,398.83 / $7,079.46
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,089.30 / $6,025.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $1,905.46