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Prescribed Medicine Blood Level

Pennsylvania rates for HCPCS 80199

A blood test that measures how much of a particular prescribed medicine is present in the bloodstream. The result lets the prescriber confirm the dose is in the range where it works without reaching a level that causes side effects.

Rates data updated July 2026.

How much does Prescribed Medicine Blood Level cost?

$22.91

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $22.91 for this service. The price depends on where it is billed: about $21.88 from a physician practice, and about $47.86 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$21.88$21.38 to $25.70
FacilityA hospital or hospital-owned outpatient department$47.86$31.62 to $74.13

How much rates vary

Facilitymedian $48 · 10th to 90th $23 to $102Professionalmedian $22 · 10th to 90th $13 to $42
$10$20$50$100facility $48professional $22

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$47.86
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$21.88
Typical High
$64.57
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$41.69
Typical High
$79.43
Cigna
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$26.92
Typical High
$43.65
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$10.72
Median
$15.85
Typical High
$38.90
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$26.92
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$19.50
Median
$26.30
Typical High
$46.77
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$47.86
Typical High
$93.33
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$16.22
Median
$21.88
Typical High
$79.43
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$67.61
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$26.92
Typical High
$26.92
United
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$26.92
Typical High
$32.36
United
Setting
Professional
Modifier
Global
Typical Low
$11.48
Median
$16.22
Typical High
$38.02

Where Pennsylvania sits

The same service costs 2.6 times more in South Dakota than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 33rd of 51

$22.91

SD $44.67CT $17.38

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.