| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $112.80 | $289.58 | $745.02 | |
Medica
| Professional | $388.47 | $960.33 | $960.33 |
Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 11-19 MeV
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $112.80 | $289.58 | $745.02 | |
Medica
| Professional | $388.47 | $960.33 | $960.33 |