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Idaho rates for HCPCS A9502

Technetium Tc 99m Tetrofosmin Diagnostic Per Study Dose Up To 40 Millicuries (Special Coverage Instructions Apply. See Mcm: 15

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.21 / $97.21 / $97.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.93 / $88.00 / $294.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.98 / $86.98 / $86.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.98 / $86.98 / $86.98
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.98 / $103.16 / $125.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $74.37 / $189.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.21 / $116.65 / $121.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.27 / $85.27 / $136.43