| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.32 | $206.32 | $273.16 | |
Highmark BCBS
| Facility | $257.89 | $257.89 | $299.81 |
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 | $206.32 | $206.32 | $273.16 | |
Highmark BCBS
| Facility | $257.89 | $257.89 | $299.81 |