| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $120.23 | $239.88 | $741.31 |
Cigna
| Facility | 26 | $40.74 | $190.55 | $269.15 |
Univera
| Facility | 26 | $138.04 | $194.98 | $512.86 |
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); with contrast material(s)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $120.23 | $239.88 | $741.31 |
Cigna
| Facility | 26 | $40.74 | $190.55 | $269.15 |
Univera
| Facility | 26 | $138.04 | $194.98 | $512.86 |