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Pennsylvania 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
$38.02 / $48.98 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.02 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $38.02
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $35.48 / $43.65
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $47.86 / $50.12
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.02 / $60.26 / $549.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $38.02 / $44.67
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $43.65 / $45.71
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $43.65 / $95.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $645.65 / $645.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $37.15 / $46.77