go back

New Hampshire rates for HCPCS A9567

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.39 / $3.39 / $232.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.40 / $3.40 / $3.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.84 / $19.92 / $19.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.32 / $17.32 / $17.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $17.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.38 / $20.38 / $20.38
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $3,000.00 / $4,410.00