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New Hampshire 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
$125.50 / $125.50 / $125.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.28 / $746.60 / $746.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$612.97 / $1,309.63 / $1,898.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.49 / $1,537.70 / $1,999.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.72 / $1,247.09 / $3,253.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.06 / $946.59 / $1,335.61
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.58 / $643.04 / $818.41