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New York 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
$346.74 / $407.38 / $891.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $416.87 / $501.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $380.19 / $616.60
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $446.68 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $2,454.71
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $38,018.94 / $38,018.94
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $426.58 / $426.58
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $676.08
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $426.58 / $426.58
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $426.58 / $426.58