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Nationwide rates for HCPCS G0481

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;8-14 Drug Class(Es) Including Metabolites(S)

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.02 / $326.27 / $881.29	Facility	$138.02	$326.27	$881.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $104.54 / $135.22	Professional	$85.59	$104.54	$135.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.53 / $168.50 / $541.79	Facility	$151.53	$168.50	$541.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.77 / $86.12 / $123.02	Professional	$45.77	$86.12	$123.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.78 / $202.64 / $439.60	Facility	$101.78	$202.64	$439.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.33 / $150.03 / $204.38	Professional	$82.33	$150.03	$204.38
United Facility/Professional Professional Modifier Low / Median / High Price $60.63 / $73.79 / $156.59	Professional	$60.63	$73.79	$156.59

Nationwide rates for HCPCS G0481

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