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South Carolina 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
$1,698.24 / $6,165.95 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,698.24 / $1,778.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,041.74 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $933.25 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,819.70