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North Dakota 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 / $6,696.09 / $6,696.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.87 / $1,029.06 / $1,239.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.76 / $1,090.28 / $1,202.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,023.25 / $2,023.25 / $2,326.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.85 / $1,304.79 / $1,614.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$862.88 / $1,239.83 / $2,120.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.20 / $1,033.20 / $1,157.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.20 / $1,033.20 / $1,157.18