| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $122.21 | $693.00 | $737.00 |
Aetna
| Professional | QX | $280.50 | $309.19 | $380.80 |
Aetna
| Professional | QZ | $632.50 | $701.50 | $809.20 |
Anes Perq Img Dstrj Px Nulyt Agt Spi/Sp Lmbr/Sac
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $122.21 | $693.00 | $737.00 |
Aetna
| Professional | QX | $280.50 | $309.19 | $380.80 |
Aetna
| Professional | QZ | $632.50 | $701.50 | $809.20 |