| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $248.09 | $792.91 | $837.59 |
Cigna
| Facility | 26 | $179.34 | $179.34 | $191.45 |
Lucent Health
| Facility | 26 | $714.54 | $769.50 | $769.50 |
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 | $248.09 | $792.91 | $837.59 |
Cigna
| Facility | 26 | $179.34 | $179.34 | $191.45 |
Lucent Health
| Facility | 26 | $714.54 | $769.50 | $769.50 |