| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,202.26 | $3,981.07 | $8,709.64 | |
Kaiser Permanente
| Professional | $204.17 | $204.17 | $1,122.02 | |
United
| Facility | $676.08 | $1,479.11 | $2,691.53 |
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 | $1,202.26 | $3,981.07 | $8,709.64 | |
Kaiser Permanente
| Professional | $204.17 | $204.17 | $1,122.02 | |
United
| Facility | $676.08 | $1,479.11 | $2,691.53 |