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Virginia 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
$425.00 / $425.00 / $464.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.00 / $425.00 / $425.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$412.82 / $425.63 / $521.39
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.28 / $728.27 / $741.47
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.16 / $465.89 / $701.25
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.82 / $855.00 / $1,176.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.93 / $500.00 / $525.00