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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
$1,348.96 / $8,511.38 / $25,703.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,023.29 / $1,122.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,513.56 / $2,570.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,288.25 / $8,511.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,023.29 / $1,071.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,513.56 / $2,570.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,023.29 / $1,412.54
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $1,230.27 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48