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Arkansas 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
$1,059.22 / $1,059.22 / $1,462.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.39 / $1,059.22 / $1,059.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.41 / $633.85 / $1,508.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$966.01 / $966.01 / $1,207.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.07 / $504.39 / $840.65