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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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$524.81 / $724.44 / $933.25
Cigna
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Cigna
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$870.96 / $870.96 / $1,071.52
MVP Health Care
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United
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$263.03 / $263.03 / $263.03
United
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$331.13 / $446.68 / $1,148.15