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New Hampshire rates for HCPCS A9554

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

Facilitymedian $138 · 10th–90th $38–$2,5700%10%10th90th$138Professionalmedian $38 · 10th–90th $36–$630%50%10th90th$38$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $38.02 / $38.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $1,023.29 / $2,818.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $38.02 / $43.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $81.28 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $37.15 / $38.02