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Iowa rates for HCPCS A9569

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

Facilitymedian $2,042 · 10th–90th $1,660–$2,1880%50%10th90th$2,042Professionalmedian $1,698 · 10th–90th $1,660–$2,0420%50%10th90th$1,698$2.0$10.0$50.0$200.0$1.0K$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
$1,659.59 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,698.24 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $1,995.26 / $4,365.16
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $2,041.74 / $2,398.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,995.26 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $3,801.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $2,754.23 / $4,365.16
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $3,019.95 / $3,019.95
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,548.13 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $2,041.74
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,698.24 / $1,698.24