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Pennsylvania rates for HCPCS A9516

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

Facilitymedian $347 · 10th–90th $115$1,2300%10%10th90th$347Professionalmedian $107 · 10th–90th $100$4570%50%10th90th$107$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $346.74 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $457.09
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $151.36
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $380.19 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $141.25 / $141.25
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $53.70
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $120.23 / $426.58
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $125.89
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $114.82 / $323.59
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $123.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $281.84 / $338.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $128.82