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Indiana 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
$4,897.79 / $11,748.98 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $5,248.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $7,585.78 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $4,365.16 / $6,606.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $3,388.44 / $3,630.78
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
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $4,168.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,128.61 / $6,165.95