| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $758.58 | $2,454.71 | $6,606.93 | |
Medica
| Facility | $138.04 | $575.44 | $2,570.40 | |
United
| Facility | $138.04 | $630.96 | $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 | $758.58 | $2,454.71 | $6,606.93 | |
Medica
| Facility | $138.04 | $575.44 | $2,570.40 | |
United
| Facility | $138.04 | $630.96 | $1,659.59 |