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Nationwide rates for HCPCS 0117U

Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5-hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3-hydroxypropyl mercapturic acid (3-HPMA), quinolinic acid, kynurenic acid), LC-MS/MS, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,479.11 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $676.08 / $933.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $1,621.81 / $4,073.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $851.14 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $1,621.81 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,230.27 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $831.76 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $501.19 / $977.24