go back

Michigan rates for HCPCS A9592

Copper Cu-64, dotatate, diagnostic, 1 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$924.00 / $1,709.40 / $8,845.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.00 / $924.00 / $981.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,041.04 / $1,433.74 / $2,549.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$914.38 / $962.50 / $1,155.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$981.75 / $981.75 / $981.75
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$940.63 / $1,039.50 / $7,451.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.00 / $1,020.25 / $1,224.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$962.50 / $962.50 / $1,039.50