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Montana rates for HCPCS A9562

Technetium Tc-99m mertiatide, diagnostic, per study dose, up to 15 mCi

Facilitymedian $1,380 · 10th–90th $589–$3,6310%20%10th90th$1,380Professionalmedian $794 · 10th–90th $347–$1,3490%20%10th90th$794$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$588.84 / $2,290.87 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $776.25 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $64,565.42 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,949.84 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $1,348.96 / $1,380.38
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $1,348.96 / $1,380.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,318.26 / $5,011.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $724.44 / $1,548.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25