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Pennsylvania rates for HCPCS A9554

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

Facilitymedian $60 · 10th–90th $38–$6460%10%20%10th90th$60Professionalmedian $38 · 10th–90th $36–$380%50%10th$38$1.0$5.0$20.0$100.0$500.0

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
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $48.98 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $38.02 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $134.90 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $47.86 / $50.12
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $70.79
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $38.02 / $38.02
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $39.81 / $45.71
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $39.81 / $95.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $44.67