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Utah rates for HCPCS A9500

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $912.01 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $107.15 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $91.20 / $138.04
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68