go back

Michigan rates for HCPCS A9517

Iodine I-131 Sodium Iodide Capsule(S) Therapeuticper Millicurie

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.07 / $171.82 / $4,167.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.64 / $45.05 / $61.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.23 / $34.45 / $61.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.97 / $24.06 / $28.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.74 / $88.54 / $88.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.84 / $107.39 / $3,750.36
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.56 / $42.84 / $55.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $75.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.84 / $42.84 / $45.45