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Michigan 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
$101.95 / $108.71 / $169.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.83 / $93.83 / $135.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.23 / $80.23 / $80.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.56 / $80.23 / $108.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.75 / $139.59 / $174.49
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.71 / $108.71 / $199.76
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.85 / $109.85 / $137.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $68.66 / $114.43