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North Carolina rates for HCPCS A4641

Radiopharmaceutical, diagnostic, not otherwise classified

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $25.70 / $26.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $114.82 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $117.49
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $165.96 / $165.96