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Colorado rates for HCPCS 0263U

Neurology (autism spectrum disorder [ASD]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, S-sulfocysteine, taurine, urate, and xanthine), liquid chromatography tandem mass spectrometry (LC-MS/MS), plasma, algorithmic analysis with result reported as negative or positive (with metabolic subtypes of ASD)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.00 / $1,578.90 / $2,760.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.50 / $607.50 / $712.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$997.50 / $2,235.00 / $3,435.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.00 / $315.00 / $550.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.00 / $658.13 / $1,930.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.88 / $861.93 / $1,077.41
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.00 / $585.00 / $957.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.50 / $975.00 / $1,387.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.00 / $315.00 / $555.00