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New Hampshire rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Facilitymedian $417 · 10th–90th $263–$1,0960%10%10th90th$417Professionalmedian $269 · 10th–90th $245–$4470%50%10th90th$269$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $309.03 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $263.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $549.54 / $954.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $269.15 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $575.44 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $269.15
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $346.74 / $467.74