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Washington, DC 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
$562.34 / $562.34 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $575.44 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,258.93 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $870.96 / $1,071.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $446.68 / $933.25