go back

Idaho rates for HCPCS A9504

Technetium Tc-99m Apcitide Diagnostic Per Study Dose Up To 20 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $500.00 / $500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.00 / $430.00 / $500.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.00 / $450.00 / $614.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $3,900.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $700.00