go back

Michigan 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
$2,137.96 / $3,801.89 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,570.40 / $3,090.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,137.96 / $3,715.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $3,090.30 / $8,912.51
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $3,311.31 / $4,466.84
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $2,290.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,570.40 / $2,818.38