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Pennsylvania rates for HCPCS 78290

Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$30.90 / $81.28 / $123.03
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$30.90 / $64.57 / $109.65
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$31.62 / $37.15 / $37.15