| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $151.18 | $151.18 | $151.18 |
Midlands
| Facility | 26 | $556.24 | $556.24 | $556.24 |
Sanford Health Plan
| Professional | 26 | $183.28 | $248.33 | $300.47 |
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 | $151.18 | $151.18 | $151.18 |
Midlands
| Facility | 26 | $556.24 | $556.24 | $556.24 |
Sanford Health Plan
| Professional | 26 | $183.28 | $248.33 | $300.47 |