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Wisconsin 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
$70.18 / $70.18 / $97.45
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$122.55 / $139.26 / $219.69
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$224.82 / $224.82 / $224.82