| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $79.34 | $79.34 | $79.34 | |
Molina
| Professional | $30.00 | $30.00 | $3,900.00 |
Radiopharmaceutical, diagnostic, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $79.34 | $79.34 | $79.34 | |
Molina
| Professional | $30.00 | $30.00 | $3,900.00 |