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Massachusetts 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
$1,925.04 / $3,312.34 / $7,141.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,488.32 / $2,643.84 / $2,954.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.10 / $3,222.98 / $5,071.41
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $11,254.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,170.59 / $3,770.43 / $8,037.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,643.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,643.84
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,388.02 / $2,085.50 / $8,090.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $4,264.51
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,954.88 / $2,954.88 / $6,940.10
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $11,254.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $3,888.00