| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.00 | $2.00 | $2.00 | |
Aetna
| Professional | $1.00 | $2.00 | $3.09 | |
Kaiser Permanente
| Professional | $21.88 | $21.88 | $21.88 |
Tc-99m from nonhighly enriched uranium source, full cost recovery add-on, per study dose
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.00 | $2.00 | $2.00 | |
Aetna
| Professional | $1.00 | $2.00 | $3.09 | |
Kaiser Permanente
| Professional | $21.88 | $21.88 | $21.88 |