| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $1,513.56 | $2,691.53 | |
United
| Facility | $338.84 | $588.84 | $1,659.59 |
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 | $141.25 | $1,513.56 | $2,691.53 | |
United
| Facility | $338.84 | $588.84 | $1,659.59 |