| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $85.00 | $200.81 | $444.30 |
Cigna
| Facility | 26 | $114.94 | $114.94 | $114.94 |
Kaiser Permanente
| Professional | 26 | $107.61 | $171.55 | $375.82 |
Mri Brain Functional W/O Physician Admnistration
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $85.00 | $200.81 | $444.30 |
Cigna
| Facility | 26 | $114.94 | $114.94 | $114.94 |
Kaiser Permanente
| Professional | 26 | $107.61 | $171.55 | $375.82 |