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Washington rates for HCPCS A9567

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

Facilitymedian $42 · 10th–90th $18–$4900%20%10th90th$42Professionalmedian $17 · 10th–90th $3–$480%20%10th90th$17$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$16.98 / $42.66 / $891.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $14.13 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $34.67 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $17.78
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $47.86 / $57.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $48.98 / $64.57
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $41.69 / $41.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $20.42 / $47.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $20.89 / $25.70
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $30.20