go back

Michigan rates for HCPCS 78831

Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (SPECT), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilation and perfusion), single day imaging, or single area or acquisition over 2 or more days

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$99.37 / $99.37 / $104.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.28 / $740.55 / $796.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.00 / $896.50 / $1,049.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.04 / $1,117.34 / $1,521.51
Health Alliance Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$69.37 / $69.37 / $99.37
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.45 / $652.21 / $903.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.24 / $505.89 / $707.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.11 / $761.42 / $1,002.64