| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $39.32 | $46.54 | $76.58 |
Medica
| Facility | 26 | $80.39 | $80.39 | $80.39 |
Quantitative differential pulmonary perfusion, including imaging when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $39.32 | $46.54 | $76.58 |
Medica
| Facility | 26 | $80.39 | $80.39 | $80.39 |