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Montana rates for HCPCS A9557

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

Facilitymedian $2,188 · 10th–90th $13–$2,2390%20%40%10th90th$2,188Professionalmedian $3,548 · 10th–90th $2,188–$3,7150%50%10th90th$3,548$20.0$100.0$500.0$2.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,630.78 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,230.27 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,890.45 / $3,890.45
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $2,187.76 / $2,187.76
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $2,187.76 / $2,187.76
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,230.27 / $4,365.16
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $407.38 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $3,801.89