| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.46 | $34.46 | $34.46 |
Sanford Health Plan
| Professional | 26 | $43.50 | $57.70 | $64.69 |
Quantitative differential pulmonary perfusion, including imaging when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $34.46 | $34.46 | $34.46 |
Sanford Health Plan
| Professional | 26 | $43.50 | $57.70 | $64.69 |