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Connecticut rates for HCPCS A9569

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

Facilitymedian $2,344 · 10th–90th $1,738–$3,9810%20%10th90th$2,344Professionalmedian $1,738 · 10th–90th $1,549–$1,7380%50%10th$1,738$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,344.23 / $2,754.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,737.80 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,630.27 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $2,089.30
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,698.24 / $1,819.70