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Wisconsin rates for HCPCS 0093U

Prescription drug monitoring, evaluation of 65 common drugs by LC-MS/MS, urine, each drug reported detected or not detected

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $169.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $50.12 / $74.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $165.96 / $169.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $45.71 / $208.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $199.53 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $89.13 / $194.98
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $213.80 / $363.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $58.88 / $295.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $37.15 / $112.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $54.95 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $144.54 / $204.17
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $295.12
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $33.11
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $131.83
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $338.84 / $467.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $74.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $37.15 / $120.23