| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.74 | $163.74 | $303.36 | |
BCBS
| Facility | $121.54 | $121.54 | $132.24 | |
Cigna
| Facility | $98.62 | $139.22 | $350.00 |
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 | $163.74 | $163.74 | $303.36 | |
BCBS
| Facility | $121.54 | $121.54 | $132.24 | |
Cigna
| Facility | $98.62 | $139.22 | $350.00 |