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Nebraska rates for HCPCS A9596

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $3,981.07 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,023.29 / $5,128.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $501.19 / $977.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $831.76 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,621.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,230.27 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,230.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $831.76 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,174.90 / $2,754.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,096.48 / $1,202.26