go back

Montana rates for HCPCS 0051U

Prescription drug monitoring, evaluation of drugs present by liquid chromatography tandem mass spectrommetry (LC-MS/MS), urine or blood, 31 drug panel, reported as quantitative results, detected or not detected, per date of service

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $181.97 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $354.81 / $354.81
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $288.40 / $380.19
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $288.40 / $380.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $354.81 / $354.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $173.78 / $309.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $87.10 / $204.17