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Utah 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
$30.90 / $30.90 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.90 / $37.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $31.62 / $31.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $26.30 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $35.48 / $47.86
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $37.15 / $45.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02