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Utah rates for HCPCS A9503

Technetium Tc 99m Medronate Diagnostic Per Study Dose Up To 30 Millicuries Special Coverage Instructions Apply. See Mcm: 1502

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.30 / $153.55 / $300.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.95 / $12.95 / $12.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.26 / $13.26 / $13.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.25 / $27.59 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.82 / $18.26 / $19.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00