go back

Pennsylvania rates for HCPCS A4641

Radiopharmaceutical, diagnostic, not otherwise classified

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $199.53 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $109.65 / $251.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100,000.00 / $100,000.00 / $100,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38,018.94 / $38,018.94 / $38,018.94
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $1,380.38
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $85.11 / $1,258.93
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $109.65 / $251.19
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $61.66 / $61.66
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $58.88 / $61.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $42.66 / $42.66