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Utah rates for HCPCS 81003

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $18.20 / $63.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $2.00 / $3.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.91 / $2.34 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $3.09 / $4.17
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.09 / $3.09 / $3.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $8.13 / $11.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.91 / $2.04
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.19 / $2.19 / $2.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $2.24 / $4.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.91 / $3.09