| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $162.18 | $251.19 | $251.19 |
Hally Health
| Professional | 26 | $147.91 | $218.78 | $1,380.38 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |
Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or other qualified health care professional (ie, psychologist), with review of test results and report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $162.18 | $251.19 | $251.19 |
Hally Health
| Professional | 26 | $147.91 | $218.78 | $1,380.38 |
Hally Health
| Facility | 26 | $100.00 | $100.00 | $100.00 |