| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $115.59 | $150.26 | $150.26 |
Cigna
| Facility | 26 | $239.29 | $239.29 | $239.29 |
Kaiser Permanente
| Professional | 26 | $150.27 | $187.26 | $435.31 |
Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire neurofunctional testing
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $115.59 | $150.26 | $150.26 |
Cigna
| Facility | 26 | $239.29 | $239.29 | $239.29 |
Kaiser Permanente
| Professional | 26 | $150.27 | $187.26 | $435.31 |