go back

New York 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
$345.00 / $400.00 / $425.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.00 / $415.00 / $425.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.00 / $373.18 / $632.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.76 / $502.76 / $502.76
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.76 / $502.76 / $502.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.68 / $331.33 / $585.50
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 / $38,249.62 / $38,249.62
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.00 / $425.00 / $425.00
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.33 / $331.33 / $597.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $700.67
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.00 / $425.00 / $425.00
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.00 / $425.00 / $425.00