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Delaware rates for HCPCS A9569

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,493.00 / $4,493.00 / $4,493.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $1,748.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $1,748.25
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,018.44 / $4,018.44 / $4,018.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,645.41 / $1,713.97 / $2,570.96