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Hawaii 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)

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Aetna
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Low / Median / High Price
$618.75 / $701.25 / $900.00
Cigna
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Professional
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Low / Median / High Price
$900.00 / $900.00 / $900.00
HMSA
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Professional
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Low / Median / High Price
$667.54 / $785.34 / $937.50
Kaiser Permanente
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Professional
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$750.00 / $900.00 / $1,125.00
United
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Professional
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Low / Median / High Price
$750.00 / $900.00 / $900.00