go back

Nebraska rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.90 / $524.65 / $1,049.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.90 / $244.90 / $244.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.45 / $500.30 / $975.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.37 / $218.19 / $220.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.79 / $321.00 / $481.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.90 / $455.73 / $1,093.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $255.10 / $382.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.93 / $261.02 / $389.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.42 / $261.02 / $481.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.35 / $255.10 / $306.12