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Hawaii rates for HCPCS A9596

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,964.00 / $9,964.00 / $9,964.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,029.06 / $1,070.64 / $6,930.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.85 / $1,351.58 / $1,590.10
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,360.93 / $1,425.06 / $1,425.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,295.64 / $1,413.42 / $1,648.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.20 / $1,431.09 / $1,590.10
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.59 / $1,071.59 / $1,071.59