| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11,399.57 | $11,399.57 | $11,399.57 | |
Martin's Point
| Professional | $11,399.57 | $11,399.57 | $11,399.57 | |
United
| Facility | $1,747.00 | $2,824.00 | $5,678.00 |
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 | |
Martin's Point
| Professional | $11,399.57 | $11,399.57 | $11,399.57 | |
United
| Facility | $1,747.00 | $2,824.00 | $5,678.00 |