| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $862.50 | $862.50 | $862.50 | |
Aetna
| Professional | $502.50 | $502.50 | $622.50 | |
United
| Professional | $315.00 | $450.00 | $1,650.00 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $862.50 | $862.50 | $862.50 | |
Aetna
| Professional | $502.50 | $502.50 | $622.50 | |
United
| Professional | $315.00 | $450.00 | $1,650.00 |