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Oklahoma rates for HCPCS 0322U

Neurology (autism spectrum disorder [ASD]), quantitative measurements of 14 acyl carnitines and microbiome-derived metabolites, liquid chromatography with tandem mass spectrometry (LC-MS/MS), plasma, results reported as negative or positive for risk of metabolic subtypes associated with ASD

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.00 / $750.00 / $1,800.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.50 / $562.50 / $600.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.50 / $487.50 / $658.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.93 / $861.93 / $1,077.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $562.50 / $2,512.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.00 / $315.00 / $750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.00 / $315.00 / $480.00