go back

Michigan rates for HCPCS A9569

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

Facilitymedian $1,862 · 10th–90th $933–$4,0740%20%10th90th$1,862Professionalmedian $1,698 · 10th–90th $1,047–$2,0420%50%10th90th$1,698$5.0$20.0$100.0$500.0$2.0K

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 / $4,073.80 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,698.24 / $1,737.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,621.81 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,737.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,041.74 / $6,309.57
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,187.76 / $2,951.21
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,862.09