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Montana rates for HCPCS A9540

Technetium Tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $1,174.90 / $3,019.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.84 / $36.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $46,773.51 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $85.11 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $51.29
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $56.23 / $56.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $56.23 / $56.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $57.54 / $218.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $58.88 / $85.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20