| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $169.15 | $169.15 | $326.29 |
Cigna
| Facility | 26 | $228.88 | $267.47 | $431.42 |
Quartz
| Facility | 26 | $532.00 | $532.00 | $532.00 |
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 | $169.15 | $169.15 | $326.29 |
Cigna
| Facility | 26 | $228.88 | $267.47 | $431.42 |
Quartz
| Facility | 26 | $532.00 | $532.00 | $532.00 |