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New Hampshire rates for HCPCS A9539

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

Facilitymedian $36 · 10th–90th $32–$630%20%10th90th$36Professionalmedian $32 · 10th–90th $29–$540%20%10th90th$32$20.0$50.0$100.0

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
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $30.90 / $31.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $67.61 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $38.02 / $38.02
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $17.38 / $23.44