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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
$222.23 / $1,164.49 / $1,526.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $195.07 / $283.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.06 / $217.07 / $680.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.73 / $283.73 / $354.66
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.92 / $283.95 / $449.39
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.01 / $193.25 / $210.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.71 / $103.71 / $148.15