| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $171.34 | $171.34 | $171.34 |
Sanford Health Plan
| Professional | 26 | $186.07 | $255.15 | $300.16 |
Test Select & Admn Functl Brain Map Phys/Qhp
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $171.34 | $171.34 | $171.34 |
Sanford Health Plan
| Professional | 26 | $186.07 | $255.15 | $300.16 |