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Utah rates for HCPCS 80177

Drug Screen Quantitative Levetiracetam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.28 / $183.75 / $238.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.02 / $10.19 / $15.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.32 / $11.64 / $36.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.79 / $15.28 / $19.10
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.25 / $15.24 / $59.66
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.14 / $10.85 / $15.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.57 / $7.60 / $7.95