go back

Utah rates for HCPCS A9510

Technetium Tc-99m Disofennin Diagnostic Per Study Dose Up To 15 Millicuries L Coverage Instructions Apply. See Mcm: 15030)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.72 / $69.72 / $169.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.72 / $69.72 / $69.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.40 / $71.40 / $71.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $56.14 / $61.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.80 / $98.33 / $103.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.80 / $79.80 / $79.80