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New Hampshire 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)

Facilitymedian $1,698 · 10th–90th $1,349–$6,0260%20%10th90th$1,698Professionalmedian $1,514 · 10th–90th $1,000–$3,9810%20%10th90th$1,514$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,513.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $3,162.28 / $4,570.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,235.94 / $8,709.64
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $891.25 / $1,348.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,290.87 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,905.46 / $5,128.61
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,584.89 / $2,089.30