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Maine rates for HCPCS G0659

Drug Test(S) Definitive Utilizing Drug Identification Methods Able To Identify Individualdrugs And Distinguish Between Structural Isomers Including But Not Limited To Gc/Ms And Lc/Ms Performed W/O Method Or Drug-Specific Calibration W/O Matrix-Matched Quality Control Material Or W/O Use Of Stable Isotope Or Other Universally Recognized Internal Standard(S) For Each Drug Drug Metabolite Or Drug Class Per Specimen; Quali-Tative Or Quantitative Per Day Any Number

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.14 / $62.14 / $132.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.33 / $50.33 / $50.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.13 / $82.96 / $444.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.86 / $24.86 / $54.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.54 / $132.54 / $132.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.68 / $32.68 / $81.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.14 / $71.90 / $110.29
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.14 / $62.14 / $100.67
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.33 / $50.33 / $62.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.28 / $38.47 / $92.99