go back

New Mexico 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 / $290.81 / $290.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.08 / $254.08 / $290.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.69 / $60.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.20 / $260.20 / $260.20
Providence
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 / $255.10