go back

Georgia rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.08 / $254.08 / $8,588.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.90 / $254.08 / $269.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$255.10 / $276.77 / $276.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $275.51 / $290.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.20 / $267.86 / $522.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.20 / $260.20 / $260.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.20 / $260.20 / $260.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.20 / $378.00 / $586.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.35 / $452.69 / $494.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $255.10 / $306.12