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Nebraska 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
$83.53 / $84.42 / $84.42
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$84.42 / $84.42 / $130.50
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$161.86 / $161.86 / $161.86
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$154.88 / $165.56 / $169.69
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$488.58 / $488.58 / $488.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$167.75 / $200.13 / $250.16
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$392.09 / $392.09 / $392.09
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$108.45 / $176.22 / $259.55
Midlands
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$262.95 / $270.61 / $488.58
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$108.45 / $171.55 / $225.93