| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.05 | $19.05 | $19.05 | |
Aetna
| Professional | $19.05 | $19.95 | $218.78 | |
Molina
| Professional | $44.67 | $44.67 | $60.26 |
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 | $19.05 | $19.05 | |
Aetna
| Professional | $19.05 | $19.95 | $218.78 | |
Molina
| Professional | $44.67 | $44.67 | $60.26 |