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New Mexico 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
$4,168.69 / $4,168.69 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,630.78 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $446.68 / $977.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $3,890.45 / $7,762.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $4,265.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,630.78 / $3,801.89 / $3,801.89