| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $270.50 | $338.12 | $465.38 | |
Medica
| Facility | $97.20 | $128.97 | $168.12 | |
Medica
| Professional | $716.38 | $716.38 | $716.38 |
Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a single treatment area, use of multiple blocks; 20 MeV or greater
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $270.50 | $338.12 | $465.38 | |
Medica
| Facility | $97.20 | $128.97 | $168.12 | |
Medica
| Professional | $716.38 | $716.38 | $716.38 |