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Ohio rates for HCPCS 78264

Gastric Emptying Imaging Study

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$35.56 / $50.85 / $127.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.87 / $305.11 / $588.28
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.15 / $50.77 / $127.40
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$218.71 / $268.31 / $512.89
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.95 / $303.95 / $303.95
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.88 / $48.79 / $60.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.00 / $241.34 / $398.02
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.47 / $45.30 / $71.17
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$154.52 / $194.20 / $329.99
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.87 / $311.87 / $311.87
Aultcare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.12 / $41.12 / $41.12
Aultcare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$270.76 / $270.76 / $270.76
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.34 / $264.30 / $532.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.58 / $369.10 / $675.56
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.20 / $50.13 / $85.99
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$209.04 / $316.33 / $596.09
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.85 / $354.46 / $613.15
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.20 / $52.98 / $101.12
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$227.97 / $312.32 / $585.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.05 / $299.85 / $441.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.53 / $343.57 / $652.78
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.33 / $43.87 / $75.43
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$163.49 / $295.08 / $577.35