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Oklahoma rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.34 / $247.96 / $251.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.90 / $247.96 / $254.08
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.76 / $260.36 / $421.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $255.10 / $312.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.10 / $255.10 / $270.41