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Wisconsin rates for HCPCS A9539

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

Facilitymedian $186 · 10th–90th $30$5890%10%20%10th90th$186Professionalmedian $31 · 10th–90th $30$950%50%10th90th$31$1.0$5.0$20.0$100.0$500.0

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
$34.67 / $186.21 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.90 / $37.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $52.48 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $50.12 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $91.20 / $104.71
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $31.62 / $38.02
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $58.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $31.62 / $38.02
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $79.43
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $54.95 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $67.61 / $100.00
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $199.53
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $75.86 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $50.12