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Tennessee 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
$1,192.50 / $1,350.00 / $2,581.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,488.32 / $2,581.63 / $2,581.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,714.80 / $2,959.13 / $3,176.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,643.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,643.84
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,813.52 / $6,940.10 / $11,106.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,254.08 / $11,254.08 / $13,327.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $2,592.00