| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $204.17 | $204.17 | $204.17 |
Technetium Tc-99m fanolesomab, diagnostic, per study dose, up to 25 mCi
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $204.17 | $204.17 | $204.17 |