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Kansas 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
$741.31 / $1,445.44 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $676.08 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $1,258.93 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,122.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $630.96 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $776.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $776.25