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Wisconsin rates for HCPCS A9566

Technetium Tc-99m fanolesomab, diagnostic, per study dose, up to 25 mCi

Facilitymedian $204 · 10th–90th $204–$2090%50%100%90th$204Professionalmedian $204 · 10th–90th $204–$2040%50%$204$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $85.11