| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $155.47 | $161.69 | $787.36 |
Cigna
| Facility | 26 | $133.99 | $133.99 | $221.45 |
Medica
| Facility | 26 | $665.92 | $681.22 | $681.22 |
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 | $155.47 | $161.69 | $787.36 |
Cigna
| Facility | 26 | $133.99 | $133.99 | $221.45 |
Medica
| Facility | 26 | $665.92 | $681.22 | $681.22 |