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Montana rates for HCPCS A9528

Iodine I-131 sodium iodide capsule(s), diagnostic, per mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.11 / $253.11 / $253.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.03 / $99.03 / $99.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.53 / $153.53 / $156.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.29 / $80.29 / $153.53
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.53 / $153.53 / $156.57
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.29 / $133.82 / $183.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.54 / $63.23 / $90.50