| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $758.58 | $2,089.30 | $5,011.87 | |
Hometown Health
| Professional | $2.63 | $151.36 | $245.47 | |
United
| Facility | $199.53 | $1,288.25 | $2,041.74 |
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 | $758.58 | $2,089.30 | $5,011.87 | |
Hometown Health
| Professional | $2.63 | $151.36 | $245.47 | |
United
| Facility | $199.53 | $1,288.25 | $2,041.74 |