go back

Maryland 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 / $4,483.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,378.42 / $4,483.93 / $5,739.43
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,220.17 / $4,220.17 / $4,220.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $4,483.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$709.95 / $835.24 / $1,826.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,275.21 / $5,275.21 / $5,433.47