| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,117.00 | $2,761.00 | $6,576.01 | |
Kaiser Permanente
| Professional | $176.01 | $365.78 | $365.78 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |
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 | $1,117.00 | $2,761.00 | $6,576.01 | |
Kaiser Permanente
| Professional | $176.01 | $365.78 | $365.78 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |