| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $155.38 | $155.38 | $155.38 | |
BCBS
| Facility | $156.44 | $189.86 | $255.43 | |
Cigna
| Facility | $161.34 | $206.26 | $392.85 |
Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $155.38 | $155.38 | $155.38 | |
BCBS
| Facility | $156.44 | $189.86 | $255.43 | |
Cigna
| Facility | $161.34 | $206.26 | $392.85 |