go back

Vermont 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
Professional
Modifier
Low / Median / High Price
$114.99 / $152.51 / $152.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.59 / $156.59 / $156.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.08 / $262.08 / $262.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.33 / $163.50 / $204.38
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.08 / $262.08 / $262.08
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.24 / $163.50 / $204.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.40 / $93.95 / $189.20