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New Hampshire rates for HCPCS A9582

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

Facilitymedian $6,918 · 10th–90th $3,631–$11,7490%10%10th90th$6,918Professionalmedian $5,248 · 10th–90th $4,898–$8,5110%50%10th90th$5,248$5.0K$10.0K$20.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $5,248.07 / $5,248.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $8,317.64 / $11,748.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,248.07 / $5,888.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $11,220.18 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $5,248.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,248.07 / $5,370.32