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Wisconsin rates for HCPCS 78216

Liver & Spleen Imaging W/Vascular Flow

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$39.58 / $39.58 / $56.84
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$67.58 / $76.80 / $121.15
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$122.62 / $122.62 / $122.62