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Ohio rates for HCPCS A9502

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.12 / $139.16 / $609.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.86 / $84.93 / $561.60
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.40 / $61.40 / $61.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.91 / $199.53 / $554.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.72 / $103.18 / $170.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.14 / $128.93 / $154.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.14 / $134.08 / $239.14
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 / $102.33
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $98.50 / $292.95
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.98 / $86.98 / $130.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.62 / $140.96 / $185.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.27 / $85.27 / $111.02