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Iowa rates for HCPCS A9572

Insium In-111 Penterotide Diagnostic Per Study Dose Up To 6 Millicuries

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,644.00 / $4,644.00 / $4,783.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.20 / $3,715.20 / $4,644.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,933.75 / $4,917.18 / $4,917.18
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $6,590.79 / $6,729.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,914.61 / $5,721.41 / $11,013.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.00 / $3,870.00 / $11,013.31
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,082.52 / $7,466.84 / $15,004.73
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,466.84 / $9,764.12 / $15,346.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.00 / $3,870.00 / $4,105.68
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,301.88 / $4,179.60 / $4,179.60