go back

New Hampshire 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 / $627.80 / $2,485.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.31 / $108.89 / $108.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $75.00 / $75.00
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.89 / $165.14 / $336.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.00 / $450.58 / $450.58
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.95 / $118.99 / $166.94