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New Hampshire rates for HCPCS A9507

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

Facilitymedian $4,467 · 10th–90th $0–$7,7620%10%20%10th90th$4,467Professionalmedian $4,467 · 10th–90th $2,042–$7,4130%50%10th90th$4,467$0.0$0.2$2.0$20.0$200.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $5,370.32
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $4,466.84 / $4,466.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $2,691.53 / $7,762.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $9,549.93 / $12,302.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,466.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $5,248.07 / $5,248.07
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,949.84 / $2,630.27