| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $257.04 | $257.04 | $257.04 | |
U of Utah Health Plan
| Professional | $251.19 | $302.00 | $416.87 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |
Thoracic target(s) delineation for stereotactic body radiation therapy (SRS/SBRT), (photon or particle beam), entire course of treatment
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $257.04 | $257.04 | $257.04 | |
U of Utah Health Plan
| Professional | $251.19 | $302.00 | $416.87 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |