| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $107.15 | $213.80 | $501.19 |
BCBS
| Facility | 26 | $112.20 | $112.20 | $112.20 |
Cigna
| Facility | 26 | $24.55 | $131.83 | $316.23 |
Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $107.15 | $213.80 | $501.19 |
BCBS
| Facility | 26 | $112.20 | $112.20 | $112.20 |
Cigna
| Facility | 26 | $24.55 | $131.83 | $316.23 |
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