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North Carolina rates for HCPCS A9569

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

Facilitymedian $2,692 · 10th–90th $1,549–$2,6920%50%10th$2,692Professionalmedian $1,698 · 10th–90th $1,413–$1,8200%50%10th90th$1,698$50.0$200.0$1.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,691.53 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,698.24 / $1,819.70
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,630.27 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,819.70 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,698.24 / $1,905.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $2,238.72
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $6,165.95
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $9,332.54