go back

Missouri 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
$97.27 / $149.33 / $199.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.27 / $99.55 / $111.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.92 / $78.72 / $207.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.55 / $240.02 / $272.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.75 / $133.06 / $164.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.50 / $199.11 / $543.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $68.66 / $129.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $68.66 / $137.32