| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $975.95 | $975.95 | $975.95 |
Mri Brain Open Intracranial Px W/O Contrast Matl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $975.95 | $975.95 | $975.95 |