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New Hampshire 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
$288.40 / $288.40 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $83.18 / $100.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $223.87 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $74.13 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $363.08 / $501.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $218.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $120.23