go back

Arizona rates for HCPCS 78264

Gastric Emptying Imaging Study

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$51.85 / $71.39 / $149.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.87 / $336.12 / $1,502.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.17 / $46.39 / $191.84
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$218.71 / $268.31 / $653.34
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.29 / $257.91 / $291.55
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$49.24 / $49.24 / $50.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.89 / $346.52 / $1,678.46
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.55 / $36.72 / $177.90
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$232.34 / $309.79 / $1,500.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.83 / $374.75 / $576.39
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.23 / $48.86 / $78.09
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$212.46 / $318.68 / $508.30
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$87.37 / $168.00 / $168.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.45 / $296.73 / $2,023.55
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.89 / $36.51 / $267.48
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$184.56 / $260.58 / $1,789.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.45 / $292.02 / $549.71
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.89 / $33.75 / $72.80
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$184.56 / $260.58 / $650.24