| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $388.00 | $388.00 | $388.00 |
Anes Xtrprtl Lwer Abd W/Urinary Tract Tot Cystec
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $388.00 | $388.00 | $388.00 |