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South Carolina 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
$4,142.60 / $4,142.60 / $16,748.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,976.07 / $4,142.60 / $4,142.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,445.72 / $5,051.95 / $6,062.34
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,287.49 / $4,142.60 / $5,557.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $4,209.96