| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $270.60 | $1,342.00 | $2,812.00 | |
United
| Facility | $130.00 | $337.00 | $858.00 |
Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $270.60 | $1,342.00 | $2,812.00 | |
United
| Facility | $130.00 | $337.00 | $858.00 |