| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $117.94 | $133.66 | $157.25 |
Cigna
| Facility | 26 | $135.26 | $135.26 | $135.26 |
Kaiser Permanente
| Professional | 26 | $128.13 | $139.78 | $163.07 |
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 | $117.94 | $133.66 | $157.25 |
Cigna
| Facility | 26 | $135.26 | $135.26 | $135.26 |
Kaiser Permanente
| Professional | 26 | $128.13 | $139.78 | $163.07 |