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Maryland 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
$994.69 / $994.69 / $6,077.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,087.97 / $5,210.58 / $5,210.58
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,356.11 / $7,356.11 / $7,356.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,210.58 / $5,210.58 / $5,210.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,335.91 / $4,950.05 / $5,823.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,108.41 / $5,108.41 / $6,130.09
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,997.51 / $3,997.51 / $3,997.51