go back

Oklahoma 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
$96.81 / $138.15 / $942.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.98 / $103.26 / $105.81
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
$103.26 / $117.72 / $217.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.24 / $106.24 / $130.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.24 / $106.24 / $112.61