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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
$1,000.00 / $6,760.83 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,023.29 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,148.15 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,288.25 / $1,621.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,230.27 / $1,819.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,584.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,202.26