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Ohio rates for HCPCS A9521

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

Facilitymedian $3,715 · 10th–90th $1,738–$4,8980%10%10th90th$3,715Professionalmedian $1,698 · 10th–90th $1,380–$2,0890%50%10th90th$1,698$20.0$100.0$500.0$2.0K$10.0K

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 / $3,715.35 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,698.24 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,715.35 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,737.80 / $2,570.40
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,365.16 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,041.74
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,754.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $60.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,238.72 / $3,890.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,737.80 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,698.24 / $1,862.09