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Missouri 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
$82.04 / $173.37 / $693.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.98 / $101.98 / $974.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.80 / $180.61 / $279.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.25 / $86.25 / $115.00
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.98 / $146.75 / $431.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.30 / $106.24 / $132.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.12 / $106.24 / $124.93