| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $80.61 | $131.22 | $310.45 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Radiation treatment delivery, 3 or more separate treatment areas, custom blocking, tangential ports, wedges, rotational beam, compensators, electron beam; 20 MeV or greater
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $80.61 | $131.22 | $310.45 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |