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Minnesota 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
$5,275.21 / $5,275.21 / $5,275.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,220.17 / $4,378.42 / $5,275.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $1,315.00 / $7,740.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.00 / $1,315.00 / $1,315.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,223.10 / $5,988.90 / $14,407.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,922.16 / $2,378.91 / $2,547.11
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,325.28 / $5,475.29 / $11,344.18
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,903.13 / $1,903.13 / $2,378.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,380.55 / $5,275.21 / $8,023.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,275.21 / $5,275.21 / $10,220.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,275.21 / $5,275.21 / $9,495.37