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Maryland rates for HCPCS A9554

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.35 / $38.25 / $38.25
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.60 / $33.60 / $33.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $38.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.34 / $42.75 / $53.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $37.50 / $45.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.40 / $640.40 / $640.40