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Maine rates for HCPCS 78492

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$90.00 / $125.00 / $265.00
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$87.53 / $106.65 / $170.70
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.34 / $135.71 / $184.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$101.81 / $117.79 / $221.01
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$90.00 / $125.00 / $265.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$86.10 / $128.01 / $167.51