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Oregon 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
$835.24 / $835.24 / $835.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,378.42 / $4,378.42 / $4,378.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,967.86 / $8,967.86 / $8,967.86
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
$2,777.15 / $3,203.31 / $3,456.21
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,777.16 / $4,597.34 / $9,413.60
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$835.24 / $1,414.24 / $2,357.06
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,044.05 / $4,378.42 / $8,967.86
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.61 / $1,044.05 / $4,483.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.24 / $835.24 / $835.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,275.21 / $5,275.21 / $6,066.49