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Louisiana 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
$102.33 / $181.04 / $443.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.93 / $102.33 / $102.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.57 / $164.57 / $164.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.27 / $129.38 / $148.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.26 / $105.26 / $107.37
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.36 / $190.36 / $190.36
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.27 / $85.27 / $106.59