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Minnesota 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 / $4,193.12 / $5,051.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $1,853.98 / $5,700.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,289.73 / $1,612.16 / $1,612.16
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 / $6,408.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,294.16 / $5,051.95 / $8,809.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $8,305.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $7,805.27