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Idaho rates for HCPCS A9569

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

Facilitymedian $1,950 · 10th–90th $1,202–$3,9810%20%40%10th90th$1,950Professionalmedian $1,738 · 10th–90th $1,698–$2,0420%50%10th90th$1,738$50.0$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
$1,949.84 / $1,949.84 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,737.80 / $2,041.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,412.54 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,995.26 / $4,786.30
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
$676.08 / $1,862.09 / $2,511.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,778.28 / $2,089.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $1,698.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,548.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,344.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,949.84 / $1,949.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24