go back

Louisiana rates for HCPCS A9569

Technetium Tx-99m Exametazime Labeled Autologous White Blood Cells Diagnostic Per Study Dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,056.76 / $2,056.76 / $2,714.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,056.76 / $2,056.76 / $2,056.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,851.08 / $1,851.08 / $2,776.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,851.08 / $1,851.08 / $1,888.10
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,456.45 / $1,456.45 / $1,456.45
Cigna
Facility/Professional
Facility
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.97 / $1,713.97 / $2,056.76