go back

Wisconsin rates for HCPCS 0145U

Drug assay, definitive, 65 or more drugs or metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, comments including sample validation, per date of service

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$304.58 / $355.92 / $546.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.75 / $158.44 / $218.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.92 / $165.92 / $165.92
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.32 / $137.32 / $165.92