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Oklahoma 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
$1,665.98 / $1,665.98 / $1,665.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,645.41 / $1,665.98 / $1,707.11
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$802.34 / $1,747.16 / $2,527.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.97 / $1,713.97 / $2,101.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,542.57 / $1,713.97 / $1,836.71