| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11,399.57 | $11,399.57 | $11,399.57 | |
Anthem BCBS
| Professional | $11.55 | $11.55 | $38.50 | |
Harvard Pilgrim
| Professional | $17,605.18 | $17,605.18 | $17,605.18 |
Focused Ultrasound Ablation/Therapeutic Inter- Vention Other Than Uterine Leiomyomata With Magnetic Resonance (Mr) Guidance(Revised 07012013)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11,399.57 | $11,399.57 | $11,399.57 | |
Anthem BCBS
| Professional | $11.55 | $11.55 | $38.50 | |
Harvard Pilgrim
| Professional | $17,605.18 | $17,605.18 | $17,605.18 |