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California rates for HCPCS Q9969

Tc-99m from nonhighly enriched uranium source, full cost recovery add-on, per study dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $1.00 / $8.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.00 / $8.00 / $8.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.48 / $19.44 / $40.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.67 / $7.00 / $10.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.66 / $20.09 / $30.43
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.81 / $10.81 / $10.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $15.00 / $100.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.43 / $2.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.81 / $10.81 / $10.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.92 / $31.92 / $31.92