go back

Alaska rates for HCPCS A9513

Lutetium Lu 177, dotatate, therapeutic, 1 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.61 / $479.61 / $1,695.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.14 / $494.14 / $494.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.13 / $311.13 / $311.13
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$706.62 / $706.62 / $706.62
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.00 / $493.00 / $774.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.00 / $704.28 / $1,162.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.13 / $311.13 / $418.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.53 / $457.53 / $476.01