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Maryland 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
$67.70 / $231.36 / $637.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.86 / $86.98 / $163.72
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.56 / $93.56 / $93.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.98 / $86.98 / $86.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.63 / $97.21 / $157.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.27 / $85.27 / $85.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.27 / $85.27 / $102.33
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.05 / $121.05 / $121.05