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Arizona rates for HCPCS 78430

Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$105.42 / $255.03 / $318.77
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$178.70 / $334.57 / $334.57