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Ohio rates for HCPCS A9500

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $190.55 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $134.90 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $97.72 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $102.33 / $151.36
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $151.36 / $165.96
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $158.49 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $181.97 / $630.96
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $151.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $128.82 / $186.21
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $81.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $467.74