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Maine rates for HCPCS A9536

Technetium Tc-99m depreotide, diagnostic, per study dose, up to 35 mCi

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,202.26 / $1,202.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $676.08 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $691.83 / $1,174.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $912.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,202.26 / $1,202.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,412.54 / $2,041.74