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Michigan rates for HCPCS A9541

Technetium Tc-99m sulfur colloid, diagnostic, per study dose, up to 20 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.85 / $175.50 / $499.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.67 / $256.67 / $292.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.44 / $121.80 / $216.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.68 / $81.77 / $98.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.99 / $201.29 / $259.73
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.73 / $301.37 / $401.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.54 / $272.70 / $272.70
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.25 / $256.67 / $610.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.67 / $283.41 / $340.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.37 / $267.37 / $292.24