| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $186.21 | |
Aetna
| Professional | $77.62 | $77.62 | $151.36 | |
Molina
| Professional | $44.67 | $50.12 | $75.86 | |
United
| Professional | $109.65 | $109.65 | $109.65 |
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 | $186.21 | |
Aetna
| Professional | $77.62 | $77.62 | $151.36 | |
Molina
| Professional | $44.67 | $50.12 | $75.86 | |
United
| Professional | $109.65 | $109.65 | $109.65 |