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Maine rates for HCPCS A9520

Technetium Tc-99m, tilmanocept, diagnostic, up to 0.5 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $645.65 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $676.08 / $676.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,041.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $676.08 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $676.08 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $1,202.26
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $812.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $645.65 / $1,148.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $676.08 / $794.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $660.69 / $954.99