| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $77.62 | |
Aetna
| Professional | $77.62 | $77.62 | $151.36 | |
Medica
| Facility | $112.20 | $213.80 | $407.38 |
Technetium Tc-99m teboroxime, diagnostic, per study dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $77.62 | |
Aetna
| Professional | $77.62 | $77.62 | $151.36 | |
Medica
| Facility | $112.20 | $213.80 | $407.38 |