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Kentucky 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
$664.11 / $689.33 / $3,739.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.11 / $689.33 / $840.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$617.03 / $846.27 / $846.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.65 / $1,345.04 / $41,999.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.72 / $1,176.91 / $15,593.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$546.41 / $641.50 / $1,008.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.56 / $1,207.51 / $4,051.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.07 / $504.39 / $840.65