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Montana rates for HCPCS A9539

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

Facilitymedian $52 · 10th–90th $1–$66,0690%20%40%10th90th$52Professionalmedian $31 · 10th–90th $30–$510%50%10th90th$31$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.90 / $30.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $64,565.42 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $128.82 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $47.86
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $51.29 / $52.48
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $51.29 / $52.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $87.10 / $331.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $50.12 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02