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Louisiana rates for HCPCS A9500

Technetium Tc-99m sestamibi, diagnostic, per study dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.10 / $348.11 / $666.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.31 / $128.10 / $179.34
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.15 / $120.98 / $153.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.34 / $115.39 / $139.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.70 / $121.70 / $124.13
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.20 / $115.20 / $115.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.99 / $109.99 / $109.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.99 / $109.99 / $109.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.58 / $450.58 / $606.39