go back

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
$552.73 / $840.65 / $3,231.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.73 / $552.73 / $588.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.91 / $1,144.16 / $2,080.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.73 / $512.79 / $846.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.53 / $1,366.05 / $4,824.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$966.01 / $966.01 / $1,207.51
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.70 / $386.70 / $495.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.07 / $731.37 / $1,475.26