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Maine rates for HCPCS A9510

Technetium Tc-99m disofenin, diagnostic, per study dose, up to 15 mCi

Facilitymedian $166 · 10th–90th $81–$1660%50%10th$166Professionalmedian $71 · 10th–90th $68–$720%50%10th90th$71$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $70.79 / $70.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $63.10 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $85.11
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $70.79 / $70.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $70.79 / $112.20