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Maine 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
$114.43 / $114.43 / $243.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.69 / $92.69 / $92.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$634.13 / $732.05 / $853.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.92 / $31.92 / $97.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.75 / $131.75 / $164.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $114.43 / $138.57
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.43 / $114.43 / $185.38
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.69 / $92.69 / $114.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.66 / $68.66 / $165.92