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Maine rates for HCPCS 78814

Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$90.00 / $125.00 / $265.00
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$105.01 / $129.97 / $208.02
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$123.67 / $165.06 / $224.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$124.07 / $143.55 / $269.33
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$93.63 / $125.00 / $265.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$89.42 / $153.35 / $201.27