go back

Pennsylvania 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
$998.58 / $3,739.65 / $4,749.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,519.67 / $3,739.65 / $3,739.65
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$360.55 / $424.18 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.18 / $424.18 / $424.18
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
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.53 / $379.53 / $379.53
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,211.33 / $3,211.33 / $3,211.33
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$998.58 / $3,739.65 / $5,347.70
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,519.67 / $3,739.65 / $4,749.35
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,739.65 / $3,739.65 / $3,739.65
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,739.65 / $3,739.65 / $3,739.65
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.18 / $424.18 / $466.60
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.18 / $424.18 / $466.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,666.33 / $3,666.33 / $4,784.56