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Pennsylvania rates for HCPCS 78453

Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.29 / $59.67 / $148.10
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$51.90 / $51.90 / $51.90
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.29 / $82.88 / $148.10
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$51.90 / $51.90 / $51.90
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.55 / $45.55 / $49.50