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New Mexico rates for HCPCS A9596

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.00 / $7,717.04 / $8,303.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.87 / $1,029.07 / $1,177.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $1,500.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$991.87 / $1,053.85 / $1,239.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.85 / $1,053.85 / $1,402.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.20 / $1,033.20 / $1,033.20