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Vermont rates for HCPCS A9584

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,839.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,643.84
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,643.84 / $2,643.84 / $2,643.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,592.00 / $2,592.00 / $5,988.56