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Wisconsin rates for HCPCS A9501

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

Facilitymedian $78 · 10th–90th $78–$1170%50%90th$78Professionalmedian $78 · 10th–90th $78–$1200%50%90th$78$100.0$200.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $120.23
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $120.23
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $323.59 / $338.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $120.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $85.11