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Wyoming 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
$108.40 / $108.40 / $110.36
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$113.32 / $113.32 / $113.32
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$287.00 / $287.00 / $471.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$164.92 / $164.92 / $322.75
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$105.12 / $202.20 / $381.71