go back

Indiana rates for HCPCS 0011U

Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds and metabolites

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $177.83 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $93.33 / $107.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $51.29 / $128.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $1,659.59 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $141.25 / $346.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $69.18 / $114.82