| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $122.38 | $122.38 | $122.38 |
Midlands
| Facility | 26 | $392.25 | $392.25 | $392.25 |
Sanford Health Plan
| Professional | 26 | $152.32 | $203.70 | $232.24 |
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 | $122.38 | $122.38 | $122.38 |
Midlands
| Facility | 26 | $392.25 | $392.25 | $392.25 |
Sanford Health Plan
| Professional | 26 | $152.32 | $203.70 | $232.24 |