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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
$70.79 / $70.79 / $97.72
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$123.03 / $144.54 / $229.09
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$107.15 / $295.12 / $295.12