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New Mexico 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
$1,440.00 / $3,126.40 / $3,126.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,440.00 / $1,809.82 / $1,809.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$859.34 / $859.34 / $859.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.08 / $709.28 / $818.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $85.00 / $2,316.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.83 / $338.63 / $4,725.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.08 / $709.28 / $893.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.37 / $690.31 / $2,618.06