| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $135.32 | $135.32 | $260.45 |
Cigna
| Facility | 26 | $182.03 | $212.71 | $343.10 |
Quartz
| Facility | 26 | $412.00 | $412.00 | $412.00 |
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; each additional vessel (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $135.32 | $135.32 | $260.45 |
Cigna
| Facility | 26 | $182.03 | $212.71 | $343.10 |
Quartz
| Facility | 26 | $412.00 | $412.00 | $412.00 |