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Oregon 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
$500.00 / $500.00 / $500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.00 / $415.00 / $498.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$822.72 / $822.72 / $822.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.81 / $432.81 / $432.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.39 / $1,241.58 / $1,339.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.00 / $593.45 / $892.25
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.39 / $957.56 / $1,002.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.00 / $593.45 / $892.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.81 / $432.81 / $2,250,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $600.00