| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $145.53 | $177.91 | $201.47 |
Kaiser Permanente
| Professional | 26 | $145.19 | $205.28 | $233.68 |
Pacific Source
| Facility | 26 | $134.69 | $176.87 | $186.26 |
Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $145.53 | $177.91 | $201.47 |
Kaiser Permanente
| Professional | 26 | $145.19 | $205.28 | $233.68 |
Pacific Source
| Facility | 26 | $134.69 | $176.87 | $186.26 |