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Utah 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
$1,500.00 / $5,242.00 / $6,862.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,500.00 / $1,500.00 / $1,500.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,781.00 / $2,012.00 / $2,313.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.75 / $506.26 / $926.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.36 / $98.78 / $572.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,414.77 / $3,092.65 / $4,735.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.86 / $875.65 / $930.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.37 / $1,290.55 / $2,524.19