go back

Utah rates for HCPCS A9520

Technetium Tc-99m Tilmanocept Diagnostic Up To 0.5 Millicuries (Code Was Deleted 12/31/05 But Reinstated On 1/1/14) Supply Of Radiopharmaceutical Diagnostic Imaging Aagent Technitium Tc-99m Sulfur Colloid Per Mci

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$534.97 / $668.07 / $2,194.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$658.93 / $658.93 / $1,045.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.81 / $674.81 / $674.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $632.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$754.20 / $929.33 / $978.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.57 / $661.57 / $661.57