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Hawaii 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
$693.54 / $786.01 / $1,008.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.78 / $1,008.78 / $1,008.78
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.22 / $880.26 / $1,050.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.65 / $1,008.78 / $1,260.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.07 / $1,008.78 / $1,260.98