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Michigan 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
$101.95 / $108.71 / $169.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.54 / $91.54 / $135.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.23 / $76.23 / $80.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.23 / $80.23 / $89.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.94 / $139.59 / $257.47
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.66 / $108.71 / $199.76
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.66 / $107.66 / $137.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $75.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $68.66 / $114.43