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Maine rates for HCPCS A9500

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.89 / $285.48 / $774.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.31 / $106.31 / $116.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.75 / $65.00 / $78.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.99 / $109.99 / $109.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.75 / $109.99 / $109.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.89 / $108.89 / $130.46
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.66 / $551.79 / $853.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.31 / $108.89 / $122.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.92 / $450.58 / $675.87