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Indiana rates for HCPCS A9521

Technetium Tc-99m exametazime, diagnostic, per study dose, up to 25 mCi

Facilitymedian $2,570 · 10th–90th $1,950–$4,0740%20%40%10th90th$2,570Professionalmedian $1,660 · 10th–90th $1,148–$1,7380%50%10th90th$1,660$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $4,073.80 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,570.40 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,148.15 / $1,862.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,445.44 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,786.30 / $4,786.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $2,884.03