| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $228.55 | $228.55 | $228.55 | |
Aetna
| Professional | $133.16 | $133.16 | $133.16 | |
Cigna
| Facility | $96.82 | $96.82 | $96.82 | |
United
| Professional | $67.03 | $99.31 | $327.71 |
Prescription drug monitoring, 14 or more classes of drugs and substances, definitive tandem mass spectrometry with chromatography, capillary blood, quantitative report with therapeutic and toxic ranges, including steady-state range for the prescribed dose when detected, per date of service
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $228.55 | $228.55 | $228.55 | |
Aetna
| Professional | $133.16 | $133.16 | $133.16 | |
Cigna
| Facility | $96.82 | $96.82 | $96.82 | |
United
| Professional | $67.03 | $99.31 | $327.71 |