| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.36 | $72.44 | $120.23 |
Martin's Point
| Facility | 26 | $32.36 | $66.07 | $114.82 |
UPMC Health Plan
| Facility | 26 | $31.62 | $31.62 | $33.88 |
Quantitative differential pulmonary perfusion, including imaging when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.36 | $72.44 | $120.23 |
Martin's Point
| Facility | 26 | $32.36 | $66.07 | $114.82 |
UPMC Health Plan
| Facility | 26 | $31.62 | $31.62 | $33.88 |