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Utah 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
$97.68 / $97.68 / $97.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$764.04 / $764.04 / $764.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.78 / $948.33 / $1,782.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.95 / $430.83 / $638.40
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$2,376.81 / $2,376.81 / $2,376.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.64 / $1,334.11 / $1,441.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.71 / $734.42 / $1,221.00