go back

Florida 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
$524.81 / $2,041.74 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $524.81 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $575.44 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,071.52 / $3,630.78
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $676.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $446.68 / $758.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $316.23 / $758.58
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $758.58