| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $101.26 | $218.40 | $627.45 | |
Medica
| Professional | $297.27 | $720.48 | $720.48 |
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 11-19 MeV
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $101.26 | $218.40 | $627.45 | |
Medica
| Professional | $297.27 | $720.48 | $720.48 |