| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $101.26 | $219.54 | $414.85 | |
Medica
| Professional | $295.44 | $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 |
|---|---|---|---|---|---|
Medica
| Facility | $101.26 | $219.54 | $414.85 | |
Medica
| Professional | $295.44 | $716.38 | $716.38 |