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Maine rates for HCPCS A9554

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $38.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.95 / $115.95 / $115.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $38.25 / $38.25
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $45.83
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.25 / $38.25 / $38.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.88 / $37.50 / $56.25