| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QX | $319.74 | $384.09 | $842.40 |
Aetna
| Professional | QY | $331.37 | $331.37 | $1,034.08 |
Anes Perq Img Dstrj Px Nulyt Agt Spi/Sp Lmbr/Sac
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | QX | $319.74 | $384.09 | $842.40 |
Aetna
| Professional | QY | $331.37 | $331.37 | $1,034.08 |