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Ohio rates for HCPCS A9507

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,220.17 / $9,621.99 / $11,732.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,220.17 / $4,220.17 / $7,306.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.03 / $0.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,193.11 / $4,165.70 / $6,666.85
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,322.33 / $1,615.52 / $1,974.52
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 / $5,275.21
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,483.93 / $4,483.93 / $5,275.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.93 / $140.96 / $226.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,275.21 / $5,275.21 / $6,910.53