| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11,399.57 | $11,399.57 | $11,399.57 | |
Horizon BCBS
| Facility | $31,281.82 | $55,519.64 | $63,531.62 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |
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 |
|---|---|---|---|---|---|
Aetna
| Professional | $11,399.57 | $11,399.57 | $11,399.57 | |
Horizon BCBS
| Facility | $31,281.82 | $55,519.64 | $63,531.62 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |