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Virginia 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
$86.98 / $295.62 / $632.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.93 / $86.98 / $147.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.86 / $81.86 / $100.88
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.56 / $93.56 / $93.56
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.63 / $137.65 / $161.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.98 / $102.33 / $143.52
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.00 / $202.80 / $352.18
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.01 / $97.21 / $125.35
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.01 / $97.21 / $125.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.27 / $85.27 / $102.33