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Massachusetts rates for HCPCS A9554

Iodine I-125 sodium iothalamate, diagnostic, per study dose, up to 10 mcCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.25 / $38.25 / $51.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $38.25 / $42.75
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $941.10
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $37.50 / $171.00
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $69.62
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $37.50 / $171.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $38.25 / $56.25