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Maryland 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
$1,535.42 / $3,814.93 / $5,261.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,581.63 / $2,643.84 / $2,839.79
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,517.36 / $2,517.36 / $2,643.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,643.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,468.00 / $2,954.88 / $3,398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $3,110.40
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,257.19 / $2,257.19 / $2,257.19