| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,483.93 | $4,483.93 | $4,483.93 | |
Cigna
| Professional | $4,483.93 | $4,483.93 | $4,483.93 | |
United
| Professional | $4,220.17 | $5,275.21 | $7,912.82 |
Indium In 111 Capromab Pendetide Diagnostic Per Study Dose Up To 10 Millicuries Special Coverage Instructions Apply. See Mcm: 1502
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,483.93 | $4,483.93 | $4,483.93 | |
Cigna
| Professional | $4,483.93 | $4,483.93 | $4,483.93 | |
United
| Professional | $4,220.17 | $5,275.21 | $7,912.82 |