| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $391.20 | $391.20 | $391.20 | |
Providence
| Facility | $193.81 | $242.26 | $391.20 | |
United
| Facility | $308.29 | $308.29 | $308.29 |
Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $391.20 | $391.20 | $391.20 | |
Providence
| Facility | $193.81 | $242.26 | $391.20 | |
United
| Facility | $308.29 | $308.29 | $308.29 |