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North Carolina 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
$44.79 / $59.54 / $82.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.02 / $318.73 / $577.42
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.79 / $46.60 / $121.94
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$271.23 / $272.87 / $500.71
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.28 / $104.85 / $155.82
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$79.00 / $117.76 / $142.22
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$378.88 / $526.39 / $744.35
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$57.28 / $57.28 / $57.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.33 / $600.45 / $923.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$56.14 / $93.23 / $144.03
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$261.91 / $511.30 / $781.15
Medcost
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$77.75 / $91.00 / $161.72
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $376.00 / $442.00
Medcost
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.75 / $77.75 / $77.75
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.70 / $656.00 / $999.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.47 / $450.42 / $996.57
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$51.72 / $69.70 / $144.24
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$280.27 / $422.01 / $875.90
Wellcare
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$118.60 / $149.71 / $242.96
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,348.14 / $2,348.14 / $2,851.13
Wellcare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$379.76 / $379.76 / $396.68
Wellcare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$2,034.68 / $2,034.68 / $2,454.38