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Hawaii rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.08 / $254.08 / $254.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.20 / $260.20 / $392.59
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.00 / $20.00 / $20.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.89 / $348.97 / $363.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $382.65 / $392.59