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Tennessee 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
$4,378.42 / $4,378.42 / $4,378.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,220.17 / $4,378.42 / $4,483.93
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 / $4,483.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,483.93 / $7,450.04 / $7,450.04
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,220.54 / $10,220.54 / $11,487.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,011.45 / $5,275.21 / $5,275.21