go back

Montana rates for HCPCS A9515

Choline C-11, diagnostic, per study dose up to 20 mCi

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,980.00 / $4,980.00 / $4,980.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,100.00 / $5,100.00 / $5,100.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,000.00 / $6,000.00 / $6,000.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,100.00 / $6,840.00 / $6,840.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,000.00 / $5,000.00 / $5,000.00