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New Jersey 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
$425.00 / $425.00 / $679.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.00 / $415.00 / $425.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.03 / $396.51 / $436.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.00 / $425.00 / $38,249.62
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.00 / $450.00 / $450.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $525.00