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Utah rates for HCPCS 0025U

Tenofovir, by liquid chromatography with tandem mass spectrometry (LC-MS/MS), urine, quantitative

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $457.09 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $70.79 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $97.72 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $30.90 / $165.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $154.88 / $457.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $97.72 / $102.33
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $114.82 / $275.42
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $100.00 / $169.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $57.54 / $74.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $39.81 / $75.86