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Idaho rates for HCPCS A9516

Iodine I-123 sodium iodide, diagnostic, per 100 mcCi, up to 999 mcCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.36 / $270.89 / $2,050.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.98 / $108.36 / $109.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.36 / $108.36 / $108.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.36 / $108.36 / $108.36
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.76 / $109.63 / $138.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $3,900.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.24 / $106.24 / $148.74