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Alaska rates for HCPCS A9569

Technetium Tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose

Facilitymedian $3,311 · 10th–90th $2,754–$4,6770%20%10th90th$3,311Professionalmedian $1,738 · 10th–90th $1,660–$2,0420%50%10th90th$1,738$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,737.80 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,981.07 / $4,677.35
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,698.24 / $2,754.23
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $4,570.88
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $3,981.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,513.56 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,570.40 / $4,786.30