| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $954.99 | $3,630.78 | $8,128.31 | |
Medica
| Facility | $54.95 | $234.42 | $1,659.59 | |
United
| Facility | $190.55 | $537.03 | $1,905.46 |
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 | $954.99 | $3,630.78 | $8,128.31 | |
Medica
| Facility | $54.95 | $234.42 | $1,659.59 | |
United
| Facility | $190.55 | $537.03 | $1,905.46 |