| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.23 | $36.93 | $56.62 |
Cigna
| Facility | 26 | $38.40 | $38.40 | $38.40 |
Medcost
| Facility | 26 | $46.10 | $80.93 | $104.22 |
Wellcare
| Facility | 26 | $80.39 | $85.00 | $163.63 |
Quantitative differential pulmonary perfusion, including imaging when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $30.23 | $36.93 | $56.62 |
Cigna
| Facility | 26 | $38.40 | $38.40 | $38.40 |
Medcost
| Facility | 26 | $46.10 | $80.93 | $104.22 |
Wellcare
| Facility | 26 | $80.39 | $85.00 | $163.63 |