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Utah rates for HCPCS G0482

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;15-21 Drug Class(Es) Including Metabolites(S)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.43 / $260.88 / $1,026.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.16 / $158.99 / $228.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.87 / $207.59 / $547.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.16 / $207.38 / $259.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.25 / $278.24 / $278.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.74 / $228.55 / $804.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.13 / $155.47 / $169.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.73 / $83.47 / $119.24