| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $120.23 | $239.88 | $758.58 |
Cigna
| Facility | 26 | $36.31 | $169.82 | $245.47 |
Univera
| Facility | 26 | $123.03 | $177.83 | $467.74 |
Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $120.23 | $239.88 | $758.58 |
Cigna
| Facility | 26 | $36.31 | $169.82 | $245.47 |
Univera
| Facility | 26 | $123.03 | $177.83 | $467.74 |