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Pennsylvania rates for HCPCS 78804

Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.61 / $60.94 / $145.94
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$53.38 / $53.38 / $53.38
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.61 / $85.29 / $149.15
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$53.38 / $53.38 / $53.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.89 / $45.89 / $62.00