go back

Ohio rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.30 / $369.77 / $680.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.90 / $244.90 / $369.77
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.65 / $596.92 / $1,658.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.00 / $38.72 / $260.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$270.22 / $270.22 / $283.73
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.22 / $270.22 / $270.22
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 / $306.12
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.20 / $260.20 / $306.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $50.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $255.10 / $306.12