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Kansas rates for HCPCS A9571

Indium In-111 labeled autologous platelets, diagnostic, per study dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,051.95 / $5,051.95 / $5,051.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,041.56 / $4,041.56 / $5,051.95
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,041.56 / $4,291.50 / $6,351.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $17,681.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $5,051.95