| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $160.16 | $513.50 | $542.42 |
Cigna
| Facility | 26 | $103.32 | $103.32 | $114.94 |
Lucent Health
| Facility | 26 | $237.22 | $492.86 | $492.86 |
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 | $160.16 | $513.50 | $542.42 |
Cigna
| Facility | 26 | $103.32 | $103.32 | $114.94 |
Lucent Health
| Facility | 26 | $237.22 | $492.86 | $492.86 |