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Montana rates for HCPCS A9554

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

Facilitymedian $65 · 10th–90th $1–$3240%50%10th90th$65Professionalmedian $37 · 10th–90th $36–$650%50%10th90th$37$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $37.15 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $323.59 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $58.88
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.12 / $64.57 / $64.57
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $64.57 / $64.57
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $213.80 / $812.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $77.62 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15