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Alaska rates for HCPCS A9596

Gallium Ga-68 gozetotide, diagnostic, (Illuccix), 1 mCi

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,238.13 / $17,238.13 / $17,238.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,029.06 / $1,673.78 / $1,673.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,053.85 / $1,053.85 / $1,053.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.85 / $1,053.85 / $1,053.85
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,239.83 / $1,673.78 / $2,343.29
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,048.68 / $1,688.12 / $7,691.46
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,791.53 / $2,597.76 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,121.76 / $1,298.88 / $1,416.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,239.83 / $1,841.16 / $3,397.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.85 / $1,346.11 / $1,416.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,549.80 / $1,549.80 / $3,099.60