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Nebraska 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 / $700.00 / $863.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.45 / $500.30 / $975.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.74 / $449.19 / $449.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$475.13 / $593.91 / $1,149.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $760.00 / $2,785.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $763.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.41 / $733.56 / $1,121.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$615.71 / $763.70 / $1,205.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$475.00 / $500.00 / $550.00