go back

Maine rates for HCPCS A9547

Indium In-111 oxyquinoline, diagnostic, per 0.5 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,996.07 / $2,996.07 / $2,996.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,147.08 / $2,147.08 / $2,147.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$747.68 / $938.53 / $2,448.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,104.98 / $2,147.08 / $2,147.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,147.08 / $2,147.08 / $2,147.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,147.08 / $2,147.08 / $2,147.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,147.08 / $2,147.08 / $2,572.42
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,996.07 / $2,996.07 / $2,996.07
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,147.08 / $2,147.08 / $2,147.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,609.31 / $2,104.98 / $3,052.22