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Minnesota 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
$5,011.87 / $5,011.87 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,168.69 / $5,011.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $3,630.78 / $7,413.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $13,182.57 / $31,622.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $4,570.88 / $5,011.87
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $12,589.25 / $24,547.09
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $5,370.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $5,011.87 / $8,709.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $4,168.69 / $8,317.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $4,168.69 / $7,585.78