go back

Illinois rates for HCPCS A9516

Iodine I-123 Sodium Iodide Capsule(S) Diagnostic Per 100 Microcuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.98 / $388.60 / $814.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.98 / $101.98 / $139.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.80 / $362.96 / $1,720.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.01 / $115.01 / $115.01
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
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.72 / $185.40 / $295.20
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.58 / $181.58 / $181.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,500.00 / $2,500.00 / $2,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.24 / $106.24 / $118.99