go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$79.43 / $91.20 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $165.96
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $69.18 / $177.83