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Mississippi 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
$1,686.54 / $1,686.54 / $2,468.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,686.54 / $2,468.11 / $2,776.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,301.33 / $1,301.33 / $1,301.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,248.38 / $1,748.25 / $1,748.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.25 / $1,748.25 / $1,748.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$936.28 / $1,040.32 / $1,756.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,645.41 / $1,713.97 / $2,228.16