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Hawaii 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
$94.40 / $106.99 / $137.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.65 / $60.65 / $60.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.32 / $137.32 / $137.32
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.23 / $135.77 / $150.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.87 / $137.32 / $160.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $137.32 / $171.65