| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $74.13 | $74.13 | $74.13 |
Health Alliance Plan
| Facility | 26 | $66.07 | $165.96 | $181.97 |
Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $74.13 | $74.13 | $74.13 |
Health Alliance Plan
| Facility | 26 | $66.07 | $165.96 | $181.97 |