| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.05 | $25.12 | $25.70 | |
Aetna
| Professional | $19.05 | $19.95 | $25.70 | |
Molina
| Professional | $39.81 | $39.81 | $60.26 | |
Wellpoint
| Professional | $50.12 | $50.12 | $50.12 |
Technetium Tc-99m sodium gluceptate, diagnostic, per study dose, up to 25 mCi
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.05 | $25.12 | $25.70 | |
Aetna
| Professional | $19.05 | $19.95 | $25.70 | |
Molina
| Professional | $39.81 | $39.81 | $60.26 | |
Wellpoint
| Professional | $50.12 | $50.12 | $50.12 |