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Illinois rates for HCPCS A9582

Iodine I-123 iobenguane, diagnostic, per study dose, up to 15 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $6,456.54 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $5,011.87 / $6,165.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $23,442.29 / $72,443.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $5,248.07 / $5,248.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,248.07 / $5,248.07
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $9,549.93 / $11,748.98
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $39.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $3,388.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,128.61 / $5,495.41