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Maine rates for HCPCS A9593

Gallium Ga-68 PSMA-11, diagnostic, (UCSF), 1 mCi

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.42 / $793.42 / $793.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$517.63 / $649.76 / $1,695.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.86 / $793.41 / $793.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.42 / $793.42 / $793.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.42 / $793.42 / $793.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.42 / $793.42 / $950.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.42 / $793.42 / $793.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.86 / $777.86 / $1,166.79