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Tennessee 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
$415.00 / $415.00 / $415.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.00 / $415.00 / $425.00
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,011.44 / $2,887.57 / $2,887.57
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,061.82 / $3,061.82 / $4,452.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.00 / $500.00 / $500.00