go back

Michigan rates for HCPCS A9501

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $630.96 / $1,096.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $407.38 / $407.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $144.54
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $151.36