go back

Maine rates for HCPCS A9557

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,715.35 / $3,715.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $891.25 / $2,454.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,890.45 / $3,890.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $3,890.45 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $6,760.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $4,570.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,715.35 / $3,715.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,801.89 / $5,495.41