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Montana rates for HCPCS A9582

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

Facilitymedian $3,890 · 10th–90th $3,802–$69,1830%50%10th90th$3,890Professionalmedian $5,129 · 10th–90th $3,890–$5,2480%50%10th90th$5,129$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $5,128.61 / $5,248.07
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,791.08 / $46,773.51 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,888.44 / $14,791.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,248.07 / $5,248.07
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,890.45 / $3,890.45
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,890.45 / $3,890.45
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,888.44 / $14,791.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,344.23 / $5,248.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61