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Wisconsin 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
$69.65 / $69.65 / $96.73
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$119.85 / $136.19 / $214.84
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$207.37 / $207.37 / $207.37