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Utah 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
Facility
Modifier
Low / Median / High Price
$223.87 / $1,202.26 / $1,548.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $194.98 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $218.78 / $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
$208.93 / $295.12 / $1,148.15
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 / $707.95
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $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
$104.71 / $104.71 / $199.53