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Washington rates for HCPCS A9504

Technetium Tc-99m apcitide, diagnostic, per study dose, up to 20 mCi

Facilitymedian $832 · 10th–90th $158–$1,3180%10%20%10th90th$832Professionalmedian $427 · 10th–90th $398–$7410%50%10th90th$427$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $426.58 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $831.76 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $223.87 / $1,348.96
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $977.24 / $1,548.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $616.60 / $1,023.29
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,000.00 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,202.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $602.56
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $616.60 / $676.08