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Kentucky rates for HCPCS A9507

Indium In 111 Capromab Pendetide Diagnostic Per Study Dose Up To 10 Millicuries Special Coverage Instructions Apply. See Mcm: 1502

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,220.17 / $4,220.17 / $23,464.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,220.17 / $4,220.17 / $4,378.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,192.10 / $3,193.12 / $3,756.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,612.83 / $1,675.35 / $1,695.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.22 / $1,497.63 / $125,998.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,518.98 / $2,518.98 / $4,483.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $6,331.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,275.21 / $5,275.21 / $5,275.21