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Florida 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
$504.39 / $798.62 / $3,640.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.39 / $546.41 / $605.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.20 / $591.08 / $3,161.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.65 / $1,024.65 / $1,280.81
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.45 / $504.39 / $996.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $70.00 / $70.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.63 / $504.39 / $756.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.23 / $353.07 / $1,094.14
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.46 / $504.39 / $504.39