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Virginia rates for HCPCS A9569

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

Facilitymedian $1,738 · 10th–90th $933$2,8180%20%10th90th$1,738Professionalmedian $1,698 · 10th–90th $1,660$1,8620%50%10th90th$1,698$20.0$50.0$100.0$200.0$500.0$1.0K$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
$1,737.80 / $1,737.80 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,698.24 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,862.09 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $2,754.23
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,467.37 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,949.84 / $2,691.53
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,041.74 / $3,090.30
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,949.84 / $2,511.89
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,949.84 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,258.93 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $2,041.74