| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $28.89 | $28.89 | $28.89 |
Medcost
| Facility | 26 | $61.77 | $90.59 | $145.10 |
Quant Differential Pulm Perfusion W/Wo Imaging
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $28.89 | $28.89 | $28.89 |
Medcost
| Facility | 26 | $61.77 | $90.59 | $145.10 |