| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $162.97 | $162.97 | $176.01 |
Hometown Health
| Professional | 26 | $1.40 | $177.38 | $238.33 |
Test Select & Admn Functl Brain Map Phys/Qhp
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $162.97 | $162.97 | $176.01 |
Hometown Health
| Professional | 26 | $1.40 | $177.38 | $238.33 |