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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
$405.00 / $405.00 / $688.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.00 / $405.00 / $415.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$405.00 / $425.25 / $2,785.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $613.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $535.80