go back

Utah 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
$4,365.16 / $4,365.16 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $4,365.16 / $5,248.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $60.26 / $4,073.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $831.76 / $1,122.02
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $870.96 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,248.07 / $5,248.07