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New Mexico rates for HCPCS A9502

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $102.33 / $478.63
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,234.13 / $69,183.10 / $81,283.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $144.54 / $144.54
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $112.20 / $158.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $87.10 / $173.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $85.11