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Utah 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
$102.33 / $549.54 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $102.33 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $100.00 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $208.93 / $549.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $104.71 / $128.82
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $114.82
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $100.00 / $169.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $69.18