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Nevada 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

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Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,621.81 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $676.08 / $812.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $707.95 / $1,995.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $616.60 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $977.24 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,202.26
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $831.76 / $1,380.38
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $831.76 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $501.19 / $1,096.48