| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $100.00 | $190.55 | $457.09 |
Cigna
| Facility | 26 | $25.12 | $141.25 | $436.52 |
Myocardial imaging, positron emission tomography (PET), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $100.00 | $190.55 | $457.09 |
Cigna
| Facility | 26 | $25.12 | $141.25 | $436.52 |
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