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Connecticut rates for HCPCS A9570

Indium In-111 labeled autologous white blood cells, diagnostic, per study dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $5,248.07 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,265.80 / $4,265.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $6,606.93 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $4,168.69 / $4,265.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $4,265.80 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $4,265.80 / $4,265.80
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $4,265.80 / $4,265.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $4,168.69 / $4,677.35