| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $787.15 | $787.15 | $787.15 | |
United
| Professional | $330.60 | $330.60 | $787.15 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $787.15 | $787.15 | $787.15 | |
United
| Professional | $330.60 | $330.60 | $787.15 |