| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $157.22 | $261.93 | $511.39 |
Cigna
| Facility | 26 | $172.08 | $172.08 | $182.83 |
Medical Mutual of Ohio
| Facility | 26 | $172.08 | $172.08 | $182.83 |
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 | $157.22 | $261.93 | $511.39 |
Cigna
| Facility | 26 | $172.08 | $172.08 | $182.83 |
Medical Mutual of Ohio
| Facility | 26 | $172.08 | $172.08 | $182.83 |