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Indiana 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
$131.59 / $343.29 / $422.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.81 / $93.83 / $114.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.92 / $343.29 / $621.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.13 / $31.92 / $68.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.43 / $143.04 / $2,524.04
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $125.87 / $154.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.38 / $216.42 / $445.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.75 / $131.75 / $164.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $68.66 / $106.90