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Idaho rates for HCPCS A9596

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,053.85 / $8,512.79 / $25,847.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.87 / $1,053.85 / $1,070.64
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
$1,029.07 / $1,119.57 / $1,364.81
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.55 / $883.71 / $962.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $1,825.67 / $3,500.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.04 / $1,525.82 / $2,543.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,017.21 / $1,413.42 / $1,472.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.20 / $1,033.20 / $1,033.20