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Michigan rates for HCPCS A9596

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $9,332.54 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,023.29 / $1,479.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,513.56 / $2,691.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,023.29 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,445.44
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $5,754.40 / $12,302.69
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,258.93 / $1,862.09
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,698.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,096.48 / $1,122.02