| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,040.00 | $1,040.00 | $1,040.00 | |
Cigna
| Professional | $1,066.90 | $1,066.90 | $1,066.90 | |
United
| Professional | $1,235.00 | $1,235.00 | $1,235.00 |
Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,040.00 | $1,040.00 | $1,040.00 | |
Cigna
| Professional | $1,066.90 | $1,066.90 | $1,066.90 | |
United
| Professional | $1,235.00 | $1,235.00 | $1,235.00 |