| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.32 | $20.32 | $20.32 | |
Aetna
| Professional | $20.32 | $20.32 | $220.00 | |
Medica
| Facility | $19.21 | $20.32 | $29.07 |
Tc99m Gluceptate
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.32 | $20.32 | $20.32 | |
Aetna
| Professional | $20.32 | $20.32 | $220.00 | |
Medica
| Facility | $19.21 | $20.32 | $29.07 |