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Maryland rates for HCPCS A9500

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.20 / $131.75 / $401.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $108.89 / $178.58
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $150.00 / $185.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.99 / $109.99 / $109.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.47 / $200.50 / $405.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.58 / $450.58 / $649.96
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.69 / $121.69 / $121.69