| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $206.72 | $206.72 | $206.72 | |
CareFirst
| Professional | $1,498.05 | $1,498.05 | $1,498.05 | |
Wellpoint
| Professional | $1,045.80 | $1,045.80 | $1,045.80 |
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 | $206.72 | $206.72 | $206.72 | |
CareFirst
| Professional | $1,498.05 | $1,498.05 | $1,498.05 | |
Wellpoint
| Professional | $1,045.80 | $1,045.80 | $1,045.80 |