| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $441.60 | $441.60 | $441.60 | |
Aetna
| Professional | $159.36 | $159.36 | $159.36 | |
United
| Professional | $80.64 | $115.20 | $422.40 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $441.60 | $441.60 | $441.60 | |
Aetna
| Professional | $159.36 | $159.36 | $159.36 | |
United
| Professional | $80.64 | $115.20 | $422.40 |