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DCIS Breast Recurrence Risk Protein Score

Pennsylvania rates for HCPCS 0295U

Estimates the chance that ductal carcinoma in situ (DCIS), an early breast cancer that has not spread outside the milk duct, will come back after treatment. Stored tumor tissue is stained to measure seven proteins (COX2, FOXA1, HER2, Ki-67, p16, PR and SIAH2), and those results are combined with clinical information into a single risk score. It reads proteins in the tissue rather than measuring gene activity.

Rates data updated July 2026.

How much does DCIS Breast Recurrence Risk Protein Score cost?

$1,549

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1,549 for this service. The price depends on where it is billed: about $1,549 from a physician practice, and about $13,490 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,549$1,148 to $1,622
FacilityA hospital or hospital-owned outpatient department$13,490$13,490 to $13,490

How much rates vary

Facilitymedian $13,490 · 10th to 90th $13,490 to $13,490Professionalmedian $1,549 · 10th to 90th $1,000 to $3,388
$1K$2K$5K$10Kfacility $13,490professional $1,549

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$13,489.63
Typical High
$13,489.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,513.56
Typical High
$1,621.81
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$4,265.80
Median
$4,265.80
Typical High
$4,265.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7,943.28
Median
$9,120.11
Typical High
$9,120.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$26,302.68
Median
$26,302.68
Typical High
$26,302.68
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$7,079.46
Median
$7,079.46
Typical High
$7,762.47
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$5,495.41
Typical High
$9,549.93
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$13,489.63
Typical High
$13,489.63
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,548.82
Typical High
$1,621.81
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$13,489.63
Typical High
$13,489.63
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$1,905.46
Typical High
$1,905.46
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,148.15
Typical High
$5,495.41

Where Pennsylvania sits

The same service costs 7.1 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 27th of 51

$1,549

MT $7,079DE $1,000

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.