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Vermont rates for HCPCS 78830

Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT) with concurrently acquired computed tomography (CT) transmission scan for anatomical review, localization and determination/detection of pathology, single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $562.34 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$54.95 / $93.33 / $245.47
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$363.08 / $489.78 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $616.60 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $691.83 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$93.33 / $100.00 / $281.84
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$537.03 / $588.84 / $1,288.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $741.31 / $2,041.74
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.79 / $107.15 / $165.96
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$416.87 / $645.65 / $1,071.52