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Ohio rates for HCPCS A9517

Iodine I-131 sodium iodide capsule(s), therapeutic, per mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.43 / $882.00 / $7,148.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.26 / $45.05 / $61.85
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.00 / $12.00 / $12.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $34.70 / $57.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.80 / $49.90 / $72.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.36 / $128.10 / $128.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.54 / $88.54 / $119.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.54 / $88.54 / $88.54
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.79 / $63.37 / $119.78
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.54 / $88.54 / $88.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $50.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.76 / $42.84 / $48.76