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South Carolina rates for HCPCS A9596

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $4,073.80 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,023.29 / $1,174.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $891.25 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,380.38 / $1,548.82
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
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,148.15 / $1,737.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $933.25 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,096.48 / $1,096.48