| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $274.83 | $274.83 | $274.83 | |
United
| Professional | $115.43 | $115.43 | $274.83 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $274.83 | $274.83 | $274.83 | |
United
| Professional | $115.43 | $115.43 | $274.83 |