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California rates for HCPCS 78803

Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$48.55 / $50.84 / $303.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.73 / $357.92 / $1,800.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.85 / $50.84 / $218.09
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$260.04 / $308.92 / $867.91
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.70 / $278.70 / $278.70
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$62.80 / $62.80 / $66.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.54 / $437.86 / $916.58
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.44 / $71.09 / $145.19
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$285.01 / $368.50 / $771.38
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.83 / $432.31 / $950.76
Blue Shield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.50 / $60.44 / $126.45
Blue Shield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$239.81 / $373.44 / $828.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.05 / $472.60 / $1,099.54
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.23 / $65.18 / $144.16
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$260.04 / $408.84 / $955.38
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.23 / $451.23 / $609.16
Contra Costa Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$55.00 / $55.00 / $74.25
Contra Costa Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$396.23 / $396.23 / $534.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.99 / $442.91 / $804.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.24 / $65.95 / $115.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$304.05 / $439.13 / $743.02
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$118.60 / $236.00 / $242.96
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,348.14 / $2,348.14 / $2,851.13
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$379.76 / $379.76 / $396.68
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$2,034.68 / $2,034.68 / $2,454.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.23 / $469.04 / $1,034.20
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$45.23 / $65.27 / $140.79
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$267.10 / $408.84 / $1,012.62
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,325.76 / $1,325.76 / $1,325.76
Sutter Health Plus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$170.87 / $170.87 / $170.87
Sutter Health Plus
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$1,154.89 / $1,154.89 / $1,154.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.62 / $401.32 / $1,202.50
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.76 / $56.66 / $153.38
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$219.12 / $347.55 / $1,008.69