| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $156.75 | $156.75 | $156.75 | |
United
| Professional | $65.84 | $65.84 | $156.75 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $156.75 | $156.75 | $156.75 | |
United
| Professional | $65.84 | $65.84 | $156.75 |