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Wisconsin rates for HCPCS 0150U

Drug assay, definitive, 120 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $354.81 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $158.49 / $223.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $173.78 / $281.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $69.18 / $91.20