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New Mexico rates for HCPCS A9539

Technetium Tc-99m Pentetate Diagnostic Per Studydose Up To 25 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.72 / $35.72 / $35.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.21 / $31.21 / $35.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.50 / $60.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.96 / $31.96 / $37.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.96 / $31.96 / $31.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.60 / $37.60 / $37.60