| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.70 | $453.77 | $574.91 | |
Highmark BCBS
| Facility | $637.14 | $637.14 | $637.14 |
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 | $371.70 | $453.77 | $574.91 | |
Highmark BCBS
| Facility | $637.14 | $637.14 | $637.14 |