| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $210.00 | $374.58 | $562.00 | |
BCBS
| Facility | $206.25 | $312.93 | $548.70 | |
Medica
| Facility | $320.14 | $711.03 | $4,992.91 |
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 | $210.00 | $374.58 | $562.00 | |
BCBS
| Facility | $206.25 | $312.93 | $548.70 | |
Medica
| Facility | $320.14 | $711.03 | $4,992.91 |