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Prescribed Medicine Blood Level

Pennsylvania rates for HCPCS 80210

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?

$25.70

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $25.70 for this service. The price depends on where it is billed: about $21.88 from a physician practice, and about $52.48 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 9 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$52.48$33.11 to $79.43

How much rates vary

Facilitymedian $52 · 10th to 90th $23 to $117Professionalmedian $22 · 10th to 90th $14 to $42
$10.0$100.0$1.0K$10.0Kfacility $52professional $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
$52.48
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$17.78
Median
$21.88
Typical High
$64.57
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$131.83
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
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$30.20
Typical High
$48.98
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$12.88
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
$20.42
Median
$26.92
Typical High
$46.77
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$67.61
Typical High
$67.61
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$52.48
Typical High
$102.33
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$21.88
Typical High
$79.43
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$29.51
Typical High
$67.61
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$26.92
Typical High
$29.51
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
$40.74

Where Pennsylvania sits

The same service costs 2.3 times more in North Dakota than in Connecticut. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $25.70 · 30th of 51
ND $41.69CT $17.78

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.