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Massachusetts 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
$4,265.80 / $4,265.80 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,168.69 / $5,011.87
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,691.53 / $15,135.61
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $4,168.69 / $22,908.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $9,549.93
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
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,737.80 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $4,265.80 / $7,079.46
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,691.53 / $15,135.61
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $4,168.69 / $22,908.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,096.48 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $4,265.80 / $5,888.44