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Oklahoma 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
$2,511.89 / $2,511.89 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,570.40 / $3,090.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,630.27 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,570.40 / $3,162.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,570.40 / $2,570.40