| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $192.00 | $192.00 | $192.00 | |
United
| Professional | $80.64 | $80.64 | $192.00 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $192.00 | $192.00 | $192.00 | |
United
| Professional | $80.64 | $80.64 | $192.00 |