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Nebraska rates for HCPCS 78491

Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,288.25 / $1,584.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $4,466.84 / $8,709.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,818.38 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $3,162.28 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $645.65 / $4,466.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $2,238.72 / $10,000.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $3,235.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,778.28 / $3,801.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $2,344.23 / $3,630.78