| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $128.05 | $167.75 | $228.71 |
Medica
| Facility | 26 | $295.85 | $455.64 | $455.64 |
Mri Brain Functional W/O Physician Admnistration
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $128.05 | $167.75 | $228.71 |
Medica
| Facility | 26 | $295.85 | $455.64 | $455.64 |