| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $118.59 | $621.76 | $1,238.93 |
Kaiser Permanente
| Professional | 26 | $159.41 | $346.19 | $346.19 |
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); without contrast material(s), followed by contrast material(s) and further sequences
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $118.59 | $621.76 | $1,238.93 |
Kaiser Permanente
| Professional | 26 | $159.41 | $346.19 | $346.19 |