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Massachusetts 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
$4,483.93 / $4,483.93 / $6,084.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,220.17 / $4,483.93 / $5,011.45
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.10 / $4,789.01 / $5,665.71
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,641.76 / $5,275.21 / $9,947.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,960.90 / $11,922.24 / $21,960.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $4,483.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $4,483.93
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,641.76 / $2,466.73 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,883.92 / $2,298.46 / $3,326.86
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $7,232.58
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $7,450.04
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $5,275.21 / $10,220.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $5,275.21 / $7,912.82