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West Virginia 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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.54 / $1,612.45 / $1,612.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,337.25 / $30,571.88 / $146,745.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,522.00 / $7,337.25 / $119,998.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,522.00 / $6,522.00 / $6,522.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26,196.70 / $26,196.70 / $26,196.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.74 / $948.50 / $2,750.65