| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $169.68 | $603.54 | $1,013.84 | |
Cigna
| Facility | $120.93 | $120.93 | $120.93 | |
Molina
| Professional | $45.00 | $85.00 | $1,500.00 | |
Providence
| Facility | $120.93 | $120.93 | $120.93 |
Unlisted procedure, medical radiation physics, dosimetry and treatment devices, and special services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $169.68 | $603.54 | $1,013.84 | |
Cigna
| Facility | $120.93 | $120.93 | $120.93 | |
Molina
| Professional | $45.00 | $85.00 | $1,500.00 | |
Providence
| Facility | $120.93 | $120.93 | $120.93 |