go back

Vermont 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
$233.09 / $233.09 / $360.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.73 / $99.13 / $99.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.43 / $114.43 / $114.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.53 / $191.53 / $191.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.16 / $119.63 / $149.53
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.53 / $191.53 / $191.53
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.96 / $119.63 / $149.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.96 / $68.66 / $251.26