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Michigan 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.23 / $148.76 / $234.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.59 / $104.54 / $125.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.42 / $175.53 / $311.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.86 / $117.44 / $158.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.44 / $156.59 / $382.69
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.78 / $101.78 / $156.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.34 / $163.50 / $204.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.23 / $139.51 / $273.35
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.65 / $104.54 / $187.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.69 / $129.66 / $175.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.33 / $62.32 / $93.95