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Test Telling Apart Mirror-Image Forms of a Drug

Wisconsin rates for HCPCS 80374

A laboratory test that separates the two mirror-image forms of a drug in a sample. Some substances exist in a pair of forms that are chemically identical but built the opposite way round, and an ordinary test cannot tell them apart. Distinguishing them can show whether a positive result comes from a legitimate medicine or from a different substance that breaks down to look the same.

Facilitymedian $44 · 10th–90th $16$1120%20%10th90th$44Professionalmedian $25 · 10th–90th $5$780%20%10th90th$25$2.0$5.0$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$194.98
Typical High
$194.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$4.79
Median
$4.79
Typical High
$70.79
Cigna
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$51.29
Typical High
$83.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$26.30
Typical High
$74.13
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$15.85
Typical High
$43.65
Medica
Setting
Facility
Modifier
Global
Typical Low
$15.85
Median
$15.85
Typical High
$112.20
Medica
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$14.13
Typical High
$42.66
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$85.11
Network Health
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Quartz
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$54.95
Typical High
$79.43
Quartz
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$151.36
United
Setting
Facility
Modifier
Global
Typical Low
$12.02
Median
$14.45
Typical High
$23.99
United
Setting
Professional
Modifier
Global
Typical Low
$10.00
Median
$13.80
Typical High
$41.69