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Maryland 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
$425.00 / $425.00 / $425.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.00 / $425.00 / $544.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.36 / $705.36 / $705.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.28 / $655.44 / $1,016.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $512.54