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Kansas rates for HCPCS A9521

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,698.24 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,905.46 / $2,570.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $7,762.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $2,041.74