go back

Pennsylvania rates for HCPCS 70554

Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$131.83 / $331.13 / $501.19
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$24.55 / $114.82 / $165.96
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$138.04 / $269.15 / $467.74
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$112.20 / $112.20 / $112.20