| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $199.50 | $199.50 | $199.50 |
Health Alliance Plan
| Facility | 26 | $158.91 | $158.91 | $199.50 |
Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $199.50 | $199.50 | $199.50 |
Health Alliance Plan
| Facility | 26 | $158.91 | $158.91 | $199.50 |