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Tennessee 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
$46.91 / $123.83 / $411.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.98 / $105.81 / $108.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.75 / $123.87 / $136.72
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.86 / $254.96 / $431.25
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$437.00 / $484.42 / $517.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.24 / $106.24 / $108.36