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Minnesota rates for HCPCS A9569

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

Facilitymedian $1,479 · 10th–90th $977–$4,0740%10%10th90th$1,479Professionalmedian $1,148 · 10th–90th $912–$1,7380%50%10th90th$1,148$1.0$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
$2,041.74 / $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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,818.38 / $6,309.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,148.15 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,258.93 / $1,479.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,818.38
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,023.29 / $1,445.44
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,570.40 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $2,041.74 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $3,630.78
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 / $3,090.30