| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $307.00 | $326.98 | $379.30 | |
Cigna
| Facility | $70.90 | $175.87 | $275.43 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 |
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 | $307.00 | $326.98 | $379.30 | |
Cigna
| Facility | $70.90 | $175.87 | $275.43 | |
Molina
| Professional | $50.00 | $50.00 | $50.00 |