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Alaska rates for HCPCS A9507

Indium In-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,378.42 / $7,121.53 / $7,121.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $4,483.93
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,183.79 / $10,183.79 / $10,183.79
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,222.59 / $1,222.59 / $1,746.58
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,252.85 / $1,252.85 / $1,252.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,183.79 / $10,183.79 / $10,183.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,222.59 / $1,554.20 / $4,483.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,275.21 / $7,912.82 / $10,641.15