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Missouri rates for HCPCS A9504

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $407.38 / $501.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $380.19 / $501.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $616.60 / $2,754.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $501.19 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $831.76 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $501.19 / $524.81