| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $79.34 | $79.34 | $79.34 | |
Medica
| Facility | $13.31 | $13.31 | $100.00 |
Radiopharmaceutical, diagnostic, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $79.34 | $79.34 | $79.34 | |
Medica
| Facility | $13.31 | $13.31 | $100.00 |