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Arizona 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
$104.27 / $175.08 / $456.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.82 / $85.82 / $456.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.51 / $285.24 / $474.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.08 / $109.21 / $155.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.81 / $178.51 / $319.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.75 / $139.59 / $174.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.50 / $84.68 / $543.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $48.06 / $91.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $48.06 / $73.58