| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.88 | $12.88 | $12.88 | |
Cigna
| Professional | $79.43 | $79.43 | $79.43 |
Radiopharmaceutical, diagnostic, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.88 | $12.88 | $12.88 | |
Cigna
| Professional | $79.43 | $79.43 | $79.43 |