| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $3,164.72 | $3,164.72 | $3,164.72 |
Aetna
| Facility | QX | $2,144.44 | $2,144.44 | $2,144.44 |
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| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QK | $3,164.72 | $3,164.72 | $3,164.72 |
Aetna
| Facility | QX | $2,144.44 | $2,144.44 | $2,144.44 |
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