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Wisconsin 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 $9,550 · 10th–90th $4,898–$25,7040%10%10th90th$9,550Professionalmedian $3,388 · 10th–90th $1,148–$17,7830%10%10th90th$3,388$100.0$500.0$2.0K$10.0K

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
$1,621.81 / $1,698.24 / $2,398.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,235.94 / $11,481.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $19,952.62 / $29,512.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,309.57 / $7,943.28 / $16,982.44
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,456.54 / $16,218.10
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32,359.37 / $32,359.37 / $36,307.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,413.10 / $19,054.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,148.15 / $26,915.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $2,691.53
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $8,128.31 / $9,332.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $12,589.25 / $17,782.79
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $10,964.78 / $25,703.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $21,877.62 / $26,915.35
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,073.80 / $4,073.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29,512.09 / $29,512.09 / $29,512.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $3,981.07