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Urine Metabolite Index For Pain Assessment

South Dakota rates for HCPCS 0117U

Helps assess someone with chronic pain by measuring chemical by-products of the body's metabolism in urine. Eleven substances are measured by mass spectrometry, among them methylmalonic acid, homocysteine, quinolinic acid and kynurenic acid, and they are combined into a single overall index.

Rates data updated June 2026.

Facilitymedian $1,622 · 10th–90th $794$1,6220%50%10th$1,622Professionalmedian $794 · 10th–90th $562$1,9950%20%10th90th$794$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$954.99
Aetna
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$794.33
Typical High
$794.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,621.81
Typical High
$1,995.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$954.99
Typical High
$3,981.07
Medica
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$1,000.00
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,949.84
Typical High
$2,290.87
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$501.19
Typical High
$1,122.02
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76