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Idaho rates for HCPCS A9557

Technetium Tc-99m bicisate, diagnostic, per study dose, up to 25 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,179.60 / $4,179.60 / $4,179.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,519.67 / $3,783.65 / $4,179.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,739.65 / $3,739.65 / $3,739.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,739.65 / $3,739.65 / $3,739.65
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.53 / $3,783.65 / $5,410.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $3,197.40 / $8,150.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,179.60 / $5,015.53 / $5,224.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,666.33 / $3,666.33 / $5,866.13