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Pennsylvania rates for HCPCS A9558

Xenon Xe-133 gas, diagnostic, per 10 mCi

Facilitymedian $275 · 10th–90th $234–$6760%20%40%10th90th$275Professionalmedian $257 · 10th–90th $245–$2690%50%10th90th$257$1.0$10.0$100.0$1.0K$10.0K

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
$257.04 / $275.42 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $257.04 / $263.03
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $38.90 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $933.25 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $416.87 / $436.52
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $309.03
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $269.15 / $489.78
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $257.04 / $257.04
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $588.84 / $707.95
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $190.55 / $281.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $190.55 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $316.23