| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $77.91 | $77.91 | $77.91 | |
Moda Health
| Facility | $111.41 | $111.41 | $111.41 | |
Providence
| Facility | $111.41 | $111.41 | $111.41 |
Technetium Tc-99m teboroxime, diagnostic, per study dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $77.91 | $77.91 | $77.91 | |
Moda Health
| Facility | $111.41 | $111.41 | $111.41 | |
Providence
| Facility | $111.41 | $111.41 | $111.41 |