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Ohio rates for HCPCS A9504

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

Facilitymedian $741 · 10th–90th $398–$1,1220%20%40%10th90th$741Professionalmedian $417 · 10th–90th $398–$5010%50%10th90th$417$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$398.11 / $741.31 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $407.38 / $426.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.03 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,122.02 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $60.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $1,096.48 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $537.03