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Massachusetts rates for HCPCS A9501

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

Facilitymedian $120 · 10th–90th $120–$1740%50%90th$120Professionalmedian $110 · 10th–90th $78–$1660%20%10th90th$110$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $95.50 / $151.36
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $5,888.44 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $114.82