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Utah 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
Facility
Modifier
Low / Median / High Price
$186.21 / $1,000.00 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $158.49 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $208.93 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $281.84 / $354.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $354.81 / $977.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $208.93 / $223.87
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $245.47 / $616.60
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $218.78 / $371.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $162.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $87.10 / $165.96