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North Dakota 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
$588.46 / $588.46 / $1,513.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.46 / $588.46 / $790.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,397.54 / $1,693.91 / $1,900.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$966.01 / $975.67 / $1,226.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.46 / $1,000.38 / $3,993.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.07 / $840.65 / $1,429.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.07 / $840.65 / $1,176.91