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New Mexico 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
$198.38 / $499.80 / $1,116.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.93 / $97.21 / $545.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.04 / $143.97 / $144.00
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $85.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.98 / $86.98 / $87.72
Providence
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 / $85.27