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Pennsylvania 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
$97.27 / $394.86 / $478.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.66 / $92.69 / $97.27
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$395.23 / $526.66 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.26 / $89.26 / $89.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.59 / $166.39 / $379.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.54 / $551.54 / $551.54
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.15 / $154.47 / $282.64
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.86 / $324.88 / $472.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.09 / $93.83 / $472.60
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.46 / $177.25 / $379.22
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.54 / $551.54 / $551.54
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.43 / $114.43 / $125.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $114.43 / $125.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $68.66 / $160.19