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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
$283.95 / $283.95 / $283.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.03 / $358.03 / $358.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.73 / $354.66 / $358.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.03 / $358.03 / $358.03
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.23 / $222.23 / $358.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.71 / $103.71 / $246.92