| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $48.00 | $136.00 |
Anes 2/3 Dgr Brn Exc/Dbrdmt W/Wo Grf Ea 9% Tbs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $48.00 | $136.00 |