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Minnesota 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
$3,110.40 / $3,110.40 / $5,243.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,488.32 / $2,839.79 / $4,602.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $2,220.92 / $4,757.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,115.07 / $2,564.52 / $2,643.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,097.15 / $8,646.52 / $20,800.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,714.63 / $3,185.16 / $3,447.57
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,800.89 / $7,904.99 / $16,378.24
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,714.63 / $2,714.63 / $3,393.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,388.02 / $2,961.60 / $5,005.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $5,113.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $4,698.78