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Kentucky 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
$630.96 / $1,047.13 / $1,862.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $616.60 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $398.11 / $588.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $11,748.98 / $46,773.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,047.13 / $14,454.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $3,715.35 / $3,715.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $776.25