go back

North Carolina rates for HCPCS A9513

Lutetium Lu 177, dotatate, therapeutic, 1 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $97,723.72 / $114,815.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $302.00 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $575.44 / $794.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $346.74 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $338.84 / $363.08
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $309.03 / $501.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $489.78 / $549.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $338.84 / $398.11
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59