go back

Oklahoma 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
$407.38 / $407.38 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $416.87 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $426.58 / $2,754.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $501.19 / $660.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19