| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $166.95 | $571.45 | $764.03 |
Mri Brain Open Intracranial Px W/Contrast Matl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $166.95 | $571.45 | $764.03 |