| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.42 | $119.42 | $119.42 | |
Aetna
| Professional | $119.42 | $119.42 | $119.42 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |
Technetium Tc-99m teboroxime, diagnostic, per study dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.42 | $119.42 | $119.42 | |
Aetna
| Professional | $119.42 | $119.42 | $119.42 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |