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Illinois rates for HCPCS 0095U

Eosinophilic esophagitis, 2 protein biomarkers (Eotaxin-3 [CCL26 {C-C motif chemokine ligand 26}] and Major Basic Protein [PRG2 {proteoglycan 2, pro eosinophil major basic protein}]), enzyme-linked immunosorbent assays (ELISA), specimen obtained by esophageal string test device, algorithm reported as probability of active or inactive eosinophilic esophagitis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,348.96 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $630.96 / $851.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,047.13 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,445.44 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $933.25 / $1,174.90
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $1,000.00 / $1,380.38
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $776.25 / $1,548.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $776.25