| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $169.84 | $169.84 | $169.84 |
Midlands
| Facility | 26 | $516.23 | $516.23 | $516.23 |
Sanford Health Plan
| Professional | 26 | $201.10 | $274.43 | $322.16 |
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 | $169.84 | $169.84 | $169.84 |
Midlands
| Facility | 26 | $516.23 | $516.23 | $516.23 |
Sanford Health Plan
| Professional | 26 | $201.10 | $274.43 | $322.16 |