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Wisconsin rates for HCPCS 78454

Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$95.49 / $95.49 / $132.41
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$164.91 / $187.39 / $295.61
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$284.58 / $284.58 / $284.58