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Nebraska rates for HCPCS A9569

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

Facilitymedian $1,047 · 10th–90th $427–$3,3110%10%20%10th90th$1,047Professionalmedian $1,660 · 10th–90th $1,660–$2,0420%50%90th$1,660$500.0$1.0K$2.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,311.31 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,737.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $501.19 / $977.24
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,698.24 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,511.89 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,819.70 / $7,762.47
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $2,570.40
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,754.23 / $4,570.88
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $2,754.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,698.24 / $2,041.74