| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,265.01 | $1,265.01 | $1,265.01 | |
Cigna
| Facility | $374.18 | $374.18 | $374.18 | |
Cigna
| Professional | $99.99 | $99.99 | $99.99 |
Unlisted miscellaneous procedure, diagnostic nuclear medicine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,265.01 | $1,265.01 | $1,265.01 | |
Cigna
| Facility | $374.18 | $374.18 | $374.18 | |
Cigna
| Professional | $99.99 | $99.99 | $99.99 |