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New Jersey rates for HCPCS A9569

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

Facilitymedian $3,236 · 10th–90th $1,259–$16,2180%10%10th90th$3,236Professionalmedian $1,738 · 10th–90th $1,660–$1,7380%50%10th$1,738$100.0$500.0$2.0K$10.0K

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
$977.24 / $4,570.88 / $41,686.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,737.80 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,041.74 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $4,365.16 / $15,488.17
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,258.93 / $2,754.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,698.24 / $1,819.70