| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $212.98 | $212.98 | $212.98 | |
Aetna
| Professional | $124.08 | $124.08 | $153.72 | |
United
| Professional | $77.78 | $111.12 | $407.44 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $212.98 | $212.98 | $212.98 | |
Aetna
| Professional | $124.08 | $124.08 | $153.72 | |
United
| Professional | $77.78 | $111.12 | $407.44 |