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Utah 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
$102.99 / $539.66 / $707.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.23 / $91.54 / $133.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.81 / $100.60 / $315.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.75 / $131.75 / $164.68
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.86 / $131.59 / $137.32
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.59 / $89.59 / $97.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.06 / $48.06 / $68.66