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Mississippi 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
$750.00 / $1,372.50 / $1,522.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.50 / $825.00 / $1,440.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,125.00 / $1,125.00 / $1,125.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.50 / $487.50 / $511.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.93 / $861.93 / $1,077.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.00 / $375.00 / $1,280.23