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Wisconsin 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
$50.98 / $50.98 / $70.56
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$88.31 / $100.35 / $158.31
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$190.00 / $190.00 / $190.00