| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $115.55 | $135.16 | $657.35 |
Cigna
| Facility | 26 | $183.86 | $183.86 | $183.86 |
Medica
| Facility | 26 | $876.64 | $1,122.16 | $1,122.16 |
Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left ventricular [LV] cardiac function, right ventricular [RV] structure and function and evaluation of vascular structures, if performed)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $115.55 | $135.16 | $657.35 |
Cigna
| Facility | 26 | $183.86 | $183.86 | $183.86 |
Medica
| Facility | 26 | $876.64 | $1,122.16 | $1,122.16 |