| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $105.83 | $105.83 | $105.83 |
Cigna
| Facility | 26 | $93.76 | $93.76 | $93.76 |
Health Alliance Plan
| Facility | 26 | $67.63 | $67.63 | $105.83 |
Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $105.83 | $105.83 | $105.83 |
Cigna
| Facility | 26 | $93.76 | $93.76 | $93.76 |
Health Alliance Plan
| Facility | 26 | $67.63 | $67.63 | $105.83 |