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New Hampshire rates for HCPCS A9584

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

Facilitymedian $3,890 · 10th–90th $2,630–$9,5500%10%10th90th$3,890Professionalmedian $2,630 · 10th–90th $2,512–$4,2660%50%10th90th$2,630$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,884.03 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,630.27 / $2,630.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $4,897.79 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,630.27 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $5,623.41 / $7,244.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,630.27
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,570.40 / $2,630.27
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,388.44 / $4,466.84