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Michigan 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
$36.00 / $36.00 / $90.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $36.00 / $38.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,135.68 / $1,569.33 / $2,781.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$997.50 / $1,050.00 / $1,260.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.70 / $38.25 / $38.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.75 / $40.50 / $66.59
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.00 / $39.75 / $47.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $37.50 / $42.00