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Montana 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
Professional
Modifier
Low / Median / High Price
$85.11 / $107.15 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $154.88 / $346.74
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $154.88 / $346.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $165.96 / $251.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $102.33 / $144.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $114.82