| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $97.98 | $200.00 | $244.00 |
Hometown Health
| Professional | 26 | $89.86 | $132.26 | $166.73 |
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 | $97.98 | $200.00 | $244.00 |
Hometown Health
| Professional | 26 | $89.86 | $132.26 | $166.73 |