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New Hampshire 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
Facility
Modifier
26
Low / Median / High Price
$371.54 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.18 / $125.89 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$83.18 / $169.82 / $245.47
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.71 / $186.21 / $245.47
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$95.50 / $158.49 / $257.04
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$89.13 / $109.65 / $218.78