| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $221.40 | $221.40 | $221.40 | |
Medica
| Facility | $223.78 | $364.70 | $4,083.73 | |
United
| Facility | $575.00 | $1,990.00 | $4,012.00 |
Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $221.40 | $221.40 | $221.40 | |
Medica
| Facility | $223.78 | $364.70 | $4,083.73 | |
United
| Facility | $575.00 | $1,990.00 | $4,012.00 |