| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $150.44 | $178.88 | $870.02 |
Cigna
| Facility | 26 | $146.44 | $146.44 | $244.28 |
Medica
| Facility | 26 | $387.23 | $753.90 | $753.90 |
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 | $150.44 | $178.88 | $870.02 |
Cigna
| Facility | 26 | $146.44 | $146.44 | $244.28 |
Medica
| Facility | 26 | $387.23 | $753.90 | $753.90 |