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Ohio 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

Facilitymedian $5,012 · 10th–90th $1,148–$114,8150%20%10th90th$5,012Professionalmedian $1,549 · 10th–90th $1,023–$3,5480%20%10th90th$1,549$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,548.82 / $1,621.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,949.84 / $5,495.41
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $41,686.94 / $114,815.36
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,760.83 / $85,113.80 / $151,356.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $5,754.40 / $9,120.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $4,365.16