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Pennsylvania 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
$4,294.14 / $4,294.16 / $9,025.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,041.56 / $4,294.16 / $4,294.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,294.16 / $4,294.16 / $4,294.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,294.16 / $4,294.16 / $4,294.16
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,650.04 / $4,294.16 / $4,294.16
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,480.51 / $3,480.51 / $3,480.51
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,294.14 / $5,453.58 / $9,025.76
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,041.56 / $4,294.16 / $5,453.58
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,069.54 / $8,694.29 / $13,465.88
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,294.16 / $4,294.16 / $4,294.16
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,294.16 / $4,294.16 / $4,294.16
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,076.93 / $4,076.93 / $4,484.62
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,076.93 / $4,076.93 / $4,484.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $5,945.89