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New Hampshire rates for HCPCS A9504

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

Facilitymedian $513 · 10th–90th $427–$8910%20%40%10th90th$513Professionalmedian $427 · 10th–90th $398–$7940%20%40%10th90th$427$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
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $426.58 / $426.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $954.99 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $501.19
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $602.56 / $812.83