| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $3,374.22 | $20,151.12 | $46,345.20 | |
Medica
| Facility | $3,312.00 | $7,729.00 | $42,567.62 | |
United
| Facility | $2,735.00 | $4,974.00 | $8,812.00 |
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 |
|---|---|---|---|---|---|
BCBS
| Facility | $3,374.22 | $20,151.12 | $46,345.20 | |
Medica
| Facility | $3,312.00 | $7,729.00 | $42,567.62 | |
United
| Facility | $2,735.00 | $4,974.00 | $8,812.00 |