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California 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

Facilitymedian $3,020 · 10th–90th $776–$4,8980%10%10th90th$3,020Professionalmedian $708 · 10th–90th $550–$1,0960%10%20%10th90th$708$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $3,467.37 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $676.08 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $4,168.69 / $4,265.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $870.96 / $1,412.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,479.11 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,023.29 / $1,288.25
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $831.76 / $1,348.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $831.76 / $1,479.11
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $977.24 / $2,137.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $776.25 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $575.44 / $831.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $501.19 / $1,584.89