go back

Florida rates for HCPCS A4642

Indium In-111 Satumomad Pendetide Diagnostic Perstudy Dose Up To 6 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,340.00 / $1,390.25 / $2,074.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,340.00 / $1,390.25 / $1,423.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.10 / $1,380.10 / $1,380.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.10 / $1,380.10 / $1,380.10
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$772.88 / $803.80 / $803.80
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$702.63 / $1,003.75 / $1,791.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $50.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,675.00 / $1,675.00 / $1,725.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.25 / $268.25 / $268.25