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Minnesota 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
$2,041.74 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,698.24 / $2,041.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,819.70 / $3,630.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $229.09 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $977.24 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $2,344.23
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $891.25 / $1,258.93
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,398.83 / $2,398.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $2,041.74 / $3,388.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $3,090.30