| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,706.14 | $3,706.14 | $3,955.04 | |
United
| Facility | $1,649.00 | $3,630.00 | $7,205.00 |
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 |
|---|---|---|---|---|---|
Aetna
| Facility | $3,706.14 | $3,706.14 | $3,955.04 | |
United
| Facility | $1,649.00 | $3,630.00 | $7,205.00 |