| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $46.83 | $113.30 | $141.61 |
Medica
| Facility | 26 | $80.39 | $151.40 | $151.40 |
Quantitative differential pulmonary perfusion, including imaging when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $46.83 | $113.30 | $141.61 |
Medica
| Facility | 26 | $80.39 | $151.40 | $151.40 |