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Rhode Island 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
$318.08 / $318.08 / $318.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.32 / $351.78 / $398.28
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$46.94 / $51.44 / $56.18
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$289.38 / $300.33 / $339.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.76 / $407.76 / $633.89
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.16 / $58.80 / $94.17
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$244.27 / $348.96 / $348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.75 / $709.35 / $807.67
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.25 / $99.43 / $106.43
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$363.50 / $609.91 / $701.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.82 / $331.53 / $671.65
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.72 / $60.43 / $88.51
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$219.55 / $347.55 / $583.14