| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $216.96 | $332.90 | $387.37 |
Medica
| Facility | 26 | $714.54 | $714.54 | $740.07 |
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 | $216.96 | $332.90 | $387.37 |
Medica
| Facility | 26 | $714.54 | $714.54 | $740.07 |