go back

Nebraska 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
$4,904.07 / $6,130.09 / $11,930.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,904.07 / $4,904.07 / $4,904.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.45 / $500.30 / $975.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,910.90 / $2,011.47 / $2,011.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,542.13 / $3,177.66 / $5,210.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.89 / $4,904.07 / $21,893.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,108.41 / $5,108.41 / $6,130.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,715.48 / $3,942.14 / $8,761.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,728.75 / $3,664.67 / $5,604.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,852.99 / $5,108.41 / $6,130.09