| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.81 | $0.81 | $1.62 | |
Aetna
| Professional | $1.10 | $1.90 | $1.90 | |
HMSA
| Professional | $2.00 | $2.00 | $2.09 |
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 | $0.81 | $0.81 | $1.62 | |
Aetna
| Professional | $1.10 | $1.90 | $1.90 | |
HMSA
| Professional | $2.00 | $2.00 | $2.09 |