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Pennsylvania rates for HCPCS 78801

Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or more days

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.85 / $47.88 / $107.42
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$38.68 / $38.68 / $38.68
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.85 / $50.66 / $108.23
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$38.68 / $38.68 / $38.68
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$33.54 / $33.54 / $42.50