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Vermont 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
$343.45 / $343.45 / $604.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.98 / $93.42 / $145.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$314.87 / $329.93 / $564.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.98 / $86.98 / $86.98
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.98 / $86.98 / $86.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.01 / $85.27 / $197.01