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North Carolina 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
$31.96 / $261.27 / $272.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.21 / $31.96 / $31.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.52 / $17.52 / $23.36
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 / $37.60
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.11 / $20.01 / $70.86
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.11 / $15.11 / $15.11
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.41 / $98.50 / $116.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.60 / $37.60 / $48.88
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.26 / $85.00 / $143.07
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.75 / $251.75 / $251.75