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Michigan rates for HCPCS A9521

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

Facilitymedian $2,089 · 10th–90th $1,023–$4,0740%10%20%10th90th$2,089Professionalmedian $1,698 · 10th–90th $933–$2,0420%50%10th90th$1,698$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 / $3,019.95 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,698.24 / $1,737.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,258.93 / $2,137.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,737.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,041.74 / $5,888.44
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,187.76 / $2,951.21
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,862.09