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Texas rates for HCPCS A9604

Sm 153 Lexidronam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,631.57 / $16,022.36 / $16,022.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,631.57 / $16,022.36 / $16,608.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,156.77 / $37,134.08 / $71,994.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,562.49 / $39,078.92 / $73,272.98
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74,249.95 / $74,249.95 / $87,927.57
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,583.64 / $19,539.46 / $34,868.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,383.82 / $3,383.82 / $3,383.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,631.57 / $16,608.54 / $26,544.36
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,608.54 / $16,608.54 / $16,608.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,282.88 / $16,282.88 / $16,282.88
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,282.88 / $18,562.49 / $25,059.36