Downloadable Forms

Here are the necessary forms to process our biomarker tests. 

SYNTap Biomarker CSF Test Specification Sheet

SYNTap Biomarker CSF Test Performance Characteristics Summary

SYNTap Biomarker CSF Test Requisition Form

Advance Beneficiary Notice (Medicare Only)

Advance Beneficiary Notice (Medicaid & Medicare)

SYNTap® Test
Performance Summary

Please enter your information to download the SYNTap Test Performance Summary

SYNTap Performance Summary

Please Note: Important Billing Info

To improve patient access to the SYNTap® Biomarker CSF Test, Amprion offers the following billing options:

  • List price of $1500, with courtesy billing for both Medicare and private insurance.
  • An affordable self-pay price of $995 (patients may qualify for financial assistance and/or interest-free payment options).
  • Prices are effective as of January 1, 2024, and are subject to change.

Please note: Amprion is a Medicare participating provider, however, the SYNTap test does not currently have Medicare coverage determination. Also, Amprion is not yet in network with most insurers.

The SYNTap Biomarker CSF Test has been issued a dedicated CPT® PLA code to be used when billing: 0393U.

For additional information, please visit our billing page.