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Connecticut 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
$831.76 / $831.76 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $549.54 / $812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,380.38 / $2,290.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $616.60 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $2,754.23 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,202.26
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $630.96 / $1,479.11