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Montana rates for HCPCS 78815

Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization imaging; skull base to mid-thigh

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$113.32 / $265.00 / $646.00
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$175.09 / $175.09 / $216.45
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$118.94 / $175.09 / $332.85
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$175.09 / $175.09 / $216.45
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$119.62 / $175.09 / $239.33
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$103.38 / $108.76 / $213.59