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Pennsylvania 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 / $7,943.28 / $17,378.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,023.29 / $1,230.27
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $6,165.95 / $7,762.47
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,165.95 / $6,165.95 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,096.48 / $1,096.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,621.81 / $3,090.30
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $8,709.64 / $16,982.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,047.13 / $1,412.54
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,096.48 / $1,288.25