| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.74 | $143.74 | $8,500.00 | |
Medica
| Facility | $143.74 | $172.26 | $431.22 |
Application of stereotactic headframe for stereotactic radiosurgery (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.74 | $143.74 | $8,500.00 | |
Medica
| Facility | $143.74 | $172.26 | $431.22 |