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Maryland rates for HCPCS A9596

Gallium Ga-68 Gozetotide Diagnostic (Illuccix) 1 Millicurie

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,606.00 / $8,714.31 / $15,864.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,004.27 / $1,053.85 / $2,824.34
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.85 / $1,053.85 / $1,053.85
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.17 / $1,177.84 / $1,472.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.20 / $1,033.20 / $1,085.38
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,015.00 / $1,015.00 / $1,015.00