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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
$450.00 / $562.50 / $3,247.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.00 / $487.50 / $540.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$376.79 / $527.51 / $2,819.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.93 / $913.97 / $1,142.46
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.97 / $450.00 / $888.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.00 / $750.00 / $1,125.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.50 / $315.00 / $976.16
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.50 / $450.00 / $450.00