| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.90 | $60.26 | $100.00 |
Hally Health
| Professional | 26 | $33.88 | $47.86 | $158.49 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Quantitative differential pulmonary perfusion, including imaging when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.90 | $60.26 | $100.00 |
Hally Health
| Professional | 26 | $33.88 | $47.86 | $158.49 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |