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New York 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
$3.40 / $288.82 / $788.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.40 / $14.33 / $33.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.20 / $368.60 / $632.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.08 / $30.08 / $30.08
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.08 / $30.08 / $30.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.32 / $19.82 / $23.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $17.32
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38,249.62 / $38,249.62 / $38,249.62
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.47 / $44.47 / $44.47
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.60 / $24.59 / $206.99
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.32 / $19.82 / $597.00
MVP Health Care
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 / $29.46
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.47 / $47.06 / $47.06
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.47 / $44.47 / $47.06