| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,436.92 | $1,436.92 | $1,436.92 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,436.92 | $1,436.92 | $1,436.92 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |