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Iowa rates for HCPCS A9584

Iodine I-123 ioflupane, diagnostic, per study dose, up to 5 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,961.60 / $2,961.60 / $4,727.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,488.32 / $2,839.79 / $4,232.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,714.63 / $2,714.63 / $3,393.28
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $5,690.00 / $5,810.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,388.02 / $2,961.60 / $4,004.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $3,551.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,880.77 / $3,360.89 / $4,513.20
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,964.04 / $2,964.04 / $2,964.04
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,755.20 / $5,105.80 / $5,759.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $2,851.20
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.72 / $2,468.00 / $2,468.00