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Montana rates for HCPCS A9552

Fluorodeoxyglucose F-18 FDG, diagnostic, per study dose, up to 45 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$710.81 / $1,453.50 / $8,770.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.64 / $313.69 / $625.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.10 / $715.94 / $1,824.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.42 / $630.42 / $630.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.10 / $715.94 / $1,824.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.20 / $394.14 / $674.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.05 / $359.05 / $359.05