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Arizona rates for HCPCS A9539

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.94 / $669.94 / $669.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.46 / $30.46 / $30.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.96 / $31.96 / $31.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.96 / $31.96 / $31.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.83 / $39.29 / $138.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.60 / $37.60 / $81.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.60 / $37.60 / $37.60