go back

New Hampshire 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
Facility
Modifier
26
Low / Median / High Price
$125.89 / $213.80 / $446.68
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$109.65 / $154.88 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$141.25 / $169.82 / $363.08
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$109.65 / $234.42 / $338.84
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$141.25 / $257.04 / $331.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$123.03 / $208.93 / $338.84
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$117.49 / $147.91 / $302.00