| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $126.80 | $126.80 | $201.87 |
Cigna
| Facility | 26 | $135.26 | $135.26 | $135.26 |
Medica
| Facility | 26 | $535.50 | $535.50 | $535.50 |
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 |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $126.80 | $126.80 | $201.87 |
Cigna
| Facility | 26 | $135.26 | $135.26 | $135.26 |
Medica
| Facility | 26 | $535.50 | $535.50 | $535.50 |