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Maine rates for HCPCS 78431

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$125.89 / $125.89 / $125.89
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.00 / $125.89 / $371.54
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.28 / $117.49 / $177.83
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.61 / $117.49 / $194.98
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.15 / $125.89 / $245.47
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.00 / $125.89 / $263.03
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.15 / $131.83 / $190.55