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Montana rates for HCPCS A9502

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

Facilitymedian $309 · 10th–90th $182–$6,7610%20%10th90th$309Professionalmedian $162 · 10th–90th $81–$5500%20%40%10th90th$162$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $478.63 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $162.18 / $549.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $46,773.51 / $91,201.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $251.19
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.41 / $269.15 / $275.42
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $269.15 / $275.42
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $251.19 / $691.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11