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Virginia 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
$2,517.36 / $2,643.84 / $6,058.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,581.63 / $2,643.84 / $2,643.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,388.02 / $2,928.72 / $4,719.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,488.32 / $2,488.32 / $3,048.19
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,517.36 / $2,517.36 / $2,643.84
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.65 / $3,013.98 / $3,545.86
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,643.84 / $3,110.40 / $4,362.34
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,462.40 / $2,954.88 / $3,810.24
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,462.40 / $2,954.88 / $3,810.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $3,110.40