| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $50.00 | $60.00 | $1,500.00 | |
United
| Facility | $1,463.63 | $1,463.63 | $1,463.63 |
Quantitative computed tomography (CT) tissue characterization, including interpretation and report, obtained without concurrent CT examination of any structure contained in previously acquired diagnostic imaging
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Molina
| Professional | $50.00 | $60.00 | $1,500.00 | |
United
| Facility | $1,463.63 | $1,463.63 | $1,463.63 |