| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $374.58 | $374.58 | $374.58 | |
Midlands
| Facility | $106.70 | $106.70 | $124.48 |
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 | $374.58 | $374.58 | $374.58 | |
Midlands
| Facility | $106.70 | $106.70 | $124.48 |