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Alaska rates for HCPCS 0328U

Drug assay, definitive, 120 or more drugs and metabolites, urine, quantitative liquid chromatography with tandem mass spectrometry (LC-MS/MS), includes specimen validity and algorithmic analysis describing drug or metabolite and presence or absence of risks for a significant patient-adverse event, per date of service

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $891.25 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $107.15 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $165.96
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $114.82 / $512.86
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $371.54
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $436.52 / $457.09
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $257.04 / $257.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $131.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $114.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $229.09 / $346.74