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Utah rates for HCPCS A9557

Technetium Tc-99m Bicisate Diagnostic Per Study Dose Up To 25 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,651.66 / $3,651.66 / $3,651.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,651.66 / $3,651.66 / $3,651.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,739.65 / $3,739.65 / $3,739.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $60.00 / $481.34
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,179.60 / $5,150.12 / $5,420.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,666.33 / $3,666.33 / $3,666.33