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Massachusetts rates for HCPCS A9500

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.09 / $196.27 / $861.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.32 / $108.89 / $1,120.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.40 / $420.92 / $818.35
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.05 / $382.99 / $739.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.99 / $440.16 / $810.76
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.66 / $212.78 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.53 / $188.54 / $272.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.89 / $108.89 / $175.64
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $257.04 / $662.25
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.99 / $450.58 / $739.96
Tufts
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.98 / $73.98 / $73.98
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.98 / $90.70 / $162.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.89 / $450.58 / $745.28