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Indiana 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
$400.00 / $400.00 / $400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $400.00 / $772.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.00 / $400.00 / $552.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.01 / $610.25 / $704.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.42 / $586.78 / $704.13
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $665.00