go back

Massachusetts rates for HCPCS A9521

Technetium Tc-99m Exametazime Diagnostic Per Study Dose Up To 25 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $2,372.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,645.41 / $1,748.25 / $1,953.92
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$768.64 / $2,038.28 / $2,411.42
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.76 / $1,713.97 / $3,231.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,305.46 / $3,948.66 / $7,273.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $1,748.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $1,748.25
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$712.74 / $1,091.18 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$801.83 / $978.26 / $1,415.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $2,819.93
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,077.92 / $2,077.92 / $4,113.52
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.97 / $1,713.97 / $7,815.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.97 / $1,713.97 / $2,570.96