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Montana rates for HCPCS 0116U

Prescription drug monitoring, enzyme immunoassay of 35 or more drugs confirmed with LC-MS/MS, oral fluid, algorithm results reported as a patient-compliance measurement with risk of drug to drug interactions for prescribed medications

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $234.42 / $239.88
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
$245.47 / $309.03 / $741.31
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $309.03 / $741.31
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 / $223.87 / $309.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $245.47