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Illinois rates for HCPCS 78433

Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $239.88 / $302.00
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$102.33 / $144.54 / $302.00
Hally Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $100.00 / $100.00