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Nebraska 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
$4,041.56 / $5,051.95 / $8,726.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,041.56 / $4,041.56 / $4,041.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.45 / $500.30 / $975.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,767.88 / $3,926.53 / $3,966.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,933.75 / $4,917.18 / $9,581.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.39 / $4,291.50 / $18,944.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $6,314.94
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,701.79 / $5,052.77 / $9,321.06
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,052.77 / $6,337.76 / $10,015.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,999.46 / $4,209.96 / $5,051.95