go back

Oregon 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
$18.50 / $516.12 / $3,353.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $3.40 / $20.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.64 / $34.64 / $34.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $17.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.09 / $49.69 / $53.62
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.56 / $29.40 / $44.20
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.33 / $38.33 / $42.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.56 / $29.40 / $44.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $17.32 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.38 / $20.38 / $23.44