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Massachusetts 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
$537.03 / $1,737.80 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $588.84 / $741.31
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $3,630.78
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $562.34 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $933.25 / $1,174.90
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,318.26
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $1,698.24
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $3,630.78
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $1,148.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $776.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $602.56 / $1,778.28