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Wisconsin rates for HCPCS A9502

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

Facilitymedian $692 · 10th–90th $158$1,1480%10%10th90th$692Professionalmedian $138 · 10th–90th $81$7940%20%10th90th$138$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $707.95 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $288.40 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $87.10 / $338.84
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $346.74 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $169.82 / $218.78
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $128.82
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $380.19 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $114.82 / $524.81
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $234.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $64.57 / $138.04
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $275.42 / $389.05
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $724.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $109.65 / $724.44
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $223.87