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North Carolina 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
$75.59 / $75.59 / $179.09
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$85.69 / $85.69 / $85.69
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$103.17 / $119.04 / $201.15
Wellcare
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$178.70 / $178.70 / $363.33