| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $100.00 | $150.00 | $304.50 | |
Medica
| Professional | $119.42 | $119.42 | $119.42 |
Technetium Tc-99m teboroxime, diagnostic, per study dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $150.00 | $150.00 | $150.00 | |
Medica
| Facility | $100.00 | $150.00 | $304.50 | |
Medica
| Professional | $119.42 | $119.42 | $119.42 |