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Alaska rates for HCPCS A9504

Technetium Tc-99m apcitide, diagnostic, per study dose, up to 20 mCi

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $426.58 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $676.08 / $954.99
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $426.58 / $676.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $676.08 / $954.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $446.68 / $630.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $758.58 / $1,380.38