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Vermont 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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$930.00 / $930.00 / $930.00
Cigna
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$1,255.31 / $1,255.31 / $1,255.31
Cigna
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$861.93 / $861.93 / $1,077.41
MVP Health Care
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$1,255.31 / $1,255.31 / $1,255.31
MVP Health Care
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$487.50 / $861.93 / $1,077.41
United
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$450.00 / $450.00 / $1,050.00