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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
$588.84 / $2,290.87 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $588.84 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $645.65 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,202.26 / $4,073.80
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $501.19 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $354.81 / $831.76
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $831.76