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Washington 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
$107.15 / $512.86 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $93.33 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $263.03 / $295.12
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $114.82 / $181.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $114.82 / $194.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $125.89 / $199.53
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $199.53 / $346.74
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $102.33 / $138.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $169.82 / $316.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $102.33 / $128.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $138.04 / $138.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $47.86 / $128.82
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $114.82 / $204.17