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New York 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
Facility
Modifier
Low / Median / High Price
$6,025.60 / $12,589.25 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,412.54 / $1,621.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $8,709.64 / $8,709.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $6,606.93 / $26,302.68
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,754.40 / $6,918.31 / $10,000.00
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,370.32 / $9,772.37
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $5,495.41 / $5,623.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,148.15 / $3,388.44
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $5,495.41 / $10,715.19