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Pennsylvania 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
$228.07 / $691.95 / $1,566.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.33 / $321.26 / $638.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.13 / $329.80 / $486.80
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.70 / $105.53 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.53 / $105.53 / $105.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.09 / $537.09 / $537.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.32 / $776.76 / $2,012.78
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.52 / $527.66 / $527.66
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.32 / $1,084.39 / $1,726.11
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.20 / $229.26 / $252.19
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.61 / $750.93 / $1,636.63
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.33 / $321.26 / $734.05
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,239.89 / $2,318.23 / $3,081.35
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.13 / $901.46 / $1,236.66
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.09 / $537.09 / $537.09
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.32 / $776.76 / $2,012.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.05 / $359.05 / $394.96
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.05 / $359.05 / $394.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.05 / $359.05 / $468.56