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Urine Metabolite Index For Pain Assessment

Vermont 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 July 2026.

Facilitymedian $832 · 10th–90th $295$1,4130%20%10th90th$832Professionalmedian $1,047 · 10th–90th $832$1,0470%50%10th$1,047$500.0$1.0K$2.0K$5.0K

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

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,202.26
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$831.76
Typical High
$1,288.25