go back

Montana rates for HCPCS A9504

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

Facilitymedian $851 · 10th–90th $15–$8710%50%10th90th$851Professionalmedian $417 · 10th–90th $398–$8710%50%10th90th$417$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $416.87 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $794.33
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.49 / $851.14 / $870.96
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $851.14 / $870.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $812.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $446.68 / $1,023.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19