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Massachusetts 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
$3,947.40 / $3,947.40 / $8,152.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.20 / $3,947.40 / $4,736.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,445.72 / $8,220.07 / $23,018.69
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.00 / $5,418.15 / $17,384.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,987.71 / $15,393.65 / $28,354.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,947.40 / $3,947.40 / $3,947.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,947.40 / $3,947.40 / $7,085.03
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,914.61 / $4,618.00 / $10,324.04
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,884.76 / $9,619.75 / $13,923.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,947.40 / $3,947.40 / $6,367.16
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,220.07 / $8,220.07 / $35,376.98
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.00 / $3,870.00 / $38,920.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.00 / $3,870.00 / $5,805.00