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Montana 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
Professional
Modifier
Low / Median / High Price
$742.75 / $796.99 / $4,219.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.44 / $131.44 / $1,026.35
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$131.44 / $131.44 / $162.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.29 / $883.59 / $1,999.61
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$131.44 / $131.44 / $162.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.67 / $916.14 / $1,243.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.33 / $637.80 / $1,289.77