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Pennsylvania 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 $7,762 · 10th–90th $7,762–$13,4900%50%90th$7,762Professionalmedian $1,549 · 10th–90th $1,023–$3,4670%20%10th90th$1,549$1.0K$2.0K$5.0K$10.0K$20.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,762.47 / $7,762.47 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,513.56 / $1,621.81
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $9,120.11 / $9,120.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26,302.68 / $26,302.68 / $26,302.68
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,079.46 / $7,762.47
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $5,495.41 / $9,549.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,513.56 / $1,621.81
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $5,495.41