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New York 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
$32.71 / $61.54 / $132.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.15 / $367.18 / $1,014.37
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.13 / $51.00 / $111.17
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$197.90 / $316.18 / $638.80
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.38 / $63.38 / $63.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.95 / $363.35 / $830.26
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.69 / $53.20 / $109.92
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$237.26 / $310.14 / $674.51
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.23 / $472.65 / $544.88
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
$266.77 / $495.23 / $1,580.91
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.65 / $67.58 / $147.84
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$228.84 / $438.57 / $1,239.34
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.50 / $409.13 / $687.50
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.22 / $61.25 / $103.29
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$265.55 / $372.02 / $616.82
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.15 / $312.50 / $547.98
Excellus BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.86 / $50.65 / $87.48
Excellus BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$69.69 / $265.55 / $467.94
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.96 / $608.96 / $608.96
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.19 / $58.53 / $105.71
MVP Health Care
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$57.28 / $57.28 / $57.28
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.97 / $531.49 / $1,258.71
MVP Health Care
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$37.93 / $67.92 / $144.00
MVP Health Care
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$231.94 / $433.49 / $1,096.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.44 / $429.39 / $925.89
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.72 / $60.89 / $121.26
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$282.13 / $389.86 / $838.63
Univera
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$53.55 / $53.55 / $177.87
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.31 / $461.84 / $926.83
Univera
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.86 / $67.45 / $144.90
Univera
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$209.46 / $394.38 / $754.61