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Maine rates for HCPCS A9567

Technetium Tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 mCi

Facilitymedian $117 · 10th–90th $110–$2000%50%10th90th$117Professionalmedian $16 · 10th–90th $3–$260%10%20%10th90th$16$5.0$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
$109.65 / $117.49 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $15.14 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.95 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $20.42 / $51.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $17.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $30.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $15.14 / $19.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $26.30 / $44.67