| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $1,864.20 | $1,864.20 | $1,864.20 |
Anes Xtrprtl Lwr Abd W/Urinary Tract Rad Prstect
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $1,864.20 | $1,864.20 | $1,864.20 |