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Louisiana rates for HCPCS A9554

Iodine I-125 Sodium Iothalamate M Diagnostic Per Study Dose Up To 10 Microcuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $45.00 / $59.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.79 / $37.79 / $56.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.79 / $37.79 / $38.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.25 / $38.25 / $38.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $38.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $37.50 / $46.88