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Montana rates for HCPCS A9512

Technetium Tc-99m Pertechnetate Diagnostic Per Millicurie

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.04 / $94.04 / $94.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.68 / $1.68 / $1.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.39 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.03 / $33.22 / $84.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $1.73 / $12.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.03 / $33.22 / $84.66
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.73 / $11.92 / $18.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.69 / $1.69 / $1.69