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Oklahoma 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
$4,092.08 / $4,092.08 / $4,092.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,041.56 / $4,092.08 / $4,193.12
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
$4,092.08 / $4,291.50 / $5,851.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $5,161.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.96 / $4,209.96 / $4,294.16