| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $184.03 | $184.03 | $227.50 |
Providence
| Facility | 26 | $184.03 | $184.03 | $227.50 |
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 |
|---|---|---|---|---|---|
Cigna
| Facility | 26 | $184.03 | $184.03 | $227.50 |
Providence
| Facility | 26 | $184.03 | $184.03 | $227.50 |