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South Dakota 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 $6,166 · 10th–90th $6,166–$8,7100%20%40%90th$6,166Professionalmedian $5,495 · 10th–90th $1,479–$14,7910%20%10th90th$5,495$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,309.57 / $6,456.54 / $12,882.50
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $8,709.64
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,698.24 / $26,915.35
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $6,456.54
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,120.11 / $14,125.38 / $15,135.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $2,290.87 / $5,495.41
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41