| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.04 | $19.69 | $434.91 | |
CareFirst
| Professional | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $79.34 | $79.34 | $79.34 |
Radiopharmaceutical, diagnostic, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.04 | $19.69 | $434.91 | |
CareFirst
| Professional | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $79.34 | $79.34 | $79.34 |