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Illinois rates for HCPCS A9507

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $4,265.80 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $4,365.16 / $5,248.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $6,025.60 / $16,982.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,454.71 / $4,677.35
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $2,187.76 / $5,248.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,248.07 / $5,623.41