go back

Maine rates for HCPCS A9558

Xenon Xe-133 Gas Diagnostic Per 10 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.20 / $260.20 / $260.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$788.74 / $788.74 / $788.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $260.20 / $260.20
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.20 / $260.20 / $311.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.20 / $260.20 / $260.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $255.10 / $382.65