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Massachusetts rates for HCPCS A9502

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $190.55 / $1,862.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $102.33 / $537.03
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $275.42 / $724.44
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $87.10 / $213.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $269.15 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $151.36 / $316.23
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $144.54
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $275.42 / $724.44
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $87.10 / $218.78
Tufts
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $6.76 / $120.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $263.03 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $87.10 / $120.23