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Montana rates for HCPCS A9509

Iodine I-123 sodium iodide, diagnostic, per mCi

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.05 / $217.05 / $217.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$291.29 / $760.51 / $1,937.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.26 / $143.26 / $291.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$291.29 / $760.51 / $1,937.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.26 / $348.36 / $496.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,170.19 / $2,170.19 / $2,170.19