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Idaho rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.81 / $330.00 / $824.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.90 / $263.26 / $290.81
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.20 / $263.26 / $376.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $222.47 / $567.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.81 / $348.97 / $363.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $255.10 / $408.16