| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $201.19 | $201.19 | $201.19 |
Medcost
| Facility | 26 | $199.04 | $268.00 | $462.54 |
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 | $201.19 | $201.19 | $201.19 |
Medcost
| Facility | 26 | $199.04 | $268.00 | $462.54 |