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Nebraska 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
$80.90 / $80.90 / $80.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.52 / $75.52 / $75.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.21 / $125.53 / $244.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.95 / $173.93 / $187.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.75 / $208.24 / $260.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.52 / $172.54 / $543.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.66 / $68.66 / $228.86
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.32 / $200.25 / $295.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.32 / $200.25 / $295.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.49 / $68.66 / $228.86