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Maine rates for HCPCS G0480

Drug Test(S) Definitive Utilizing (1) Drug Identification Methods Able To Identify Individualdrugs And Distinguish Between Structural Isomers Including But Not Limited To Gc/Ms And Lc/Ms (2) Stable Isotope Or Other Universally Recognized Internal Standards In All Samples And (3) Method Or Drug-Specific Calibration And Matrix-Matched Quality Control Material; Qualitative Or Quantita-Tive Includes Specimen Validity Testing Per Day;1-7 Drug Class(Es) Including Metabolites(S)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.80 / $282.25 / $977.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.95 / $92.69 / $171.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.73 / $152.76 / $571.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.77 / $45.77 / $74.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.08 / $244.08 / $244.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.16 / $60.16 / $149.53
Community Health Options
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.75 / $600.75 / $600.75
Community Health Options
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.72 / $116.72 / $175.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $132.40 / $203.10
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.98 / $280.26 / $908.17
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.95 / $114.43 / $167.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.96 / $68.66 / $119.91