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New Hampshire 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
$128.16 / $281.61 / $801.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.09 / $80.09 / $92.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.24 / $221.51 / $569.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.77 / $74.37 / $74.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.63 / $417.76 / $501.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $166.08 / $376.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $68.66 / $68.66
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.44 / $99.79 / $2,500.00