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Indiana rates for HCPCS A9596

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$991.87 / $3,585.12 / $6,168.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.87 / $991.87 / $1,029.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.55 / $1,023.10 / $2,066.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$958.80 / $984.00 / $1,397.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,464.56 / $1,464.56 / $2,006.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,464.56 / $1,464.56 / $1,757.47
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 / $1,239.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.20 / $1,033.20 / $1,239.83