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Utah rates for HCPCS A9584

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

Facilitymedian $3,311 · 10th–90th $2,570–$3,4670%50%10th90th$3,311Professionalmedian $2,570 · 10th–90th $2,512–$3,0900%50%10th90th$2,570$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$2,570.40 / $3,311.31 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,630.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $3,235.94
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,818.38 / $3,981.07
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,890.45
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,818.38 / $3,630.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40