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Illinois rates for HCPCS A9502

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $537.03 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $107.15 / $562.34
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $114.82 / $416.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $758.58 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $346.74 / $1,096.48
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $263.03 / $263.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $91.20