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Louisiana rates for HCPCS A9502

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $204.17 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $102.33 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $104.71 / $165.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $104.71 / $104.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $104.71
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
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
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $165.96 / $190.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $102.33