| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $1,412.54 | |
CareSource
| Facility | $173.78 | $173.78 | $218.78 | |
Cigna
| Facility | $34.67 | $281.84 | $281.84 | |
United
| Facility | $457.09 | $457.09 | $457.09 |
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 | $162.18 | $162.18 | $1,412.54 | |
CareSource
| Facility | $173.78 | $173.78 | $218.78 | |
Cigna
| Facility | $34.67 | $281.84 | $281.84 | |
United
| Facility | $457.09 | $457.09 | $457.09 |