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New Hampshire rates for HCPCS A9568

Technetium Tc-99m arcitumomab, diagnostic, per study dose, up to 45 mCi

Facilitymedian $1,096 · 10th–90th $0–$1,8200%20%10th90th$1,096Professionalmedian $1,148 · 10th–90th $1,047–$2,0420%50%10th90th$1,148$0.0$0.2$2.0$20.0$200.0$2.0K

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
$1,096.48 / $1,096.48 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,096.48 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,344.23 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,584.89 / $2,089.30