go back

Kansas 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
$812.83 / $1,548.82 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $724.44 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $1,380.38 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $977.24 / $1,230.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $691.83 / $1,479.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $501.19 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $831.76 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $501.19 / $831.76