| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $179.28 | $3,038.00 | $4,387.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |
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 | $179.28 | $3,038.00 | $4,387.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |