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Maryland 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
$25.71 / $1,843.90 / $2,395.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,707.11 / $1,748.25 / $1,748.25
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,645.41 / $1,645.41 / $1,645.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $1,748.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,660.83 / $1,849.97 / $2,158.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.97 / $1,713.97 / $2,472.40
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.66 / $567.66 / $567.66