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Oregon rates for HCPCS A9502

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $162.18 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $87.10 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $173.78 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $281.84 / $416.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $151.36 / $363.08
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $97.72 / $562.34
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $323.59
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $120.23 / $288.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $87.10 / $245.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $97.72 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $102.33