| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,263.53 | $1,263.53 | $1,263.53 | |
United
| Professional | $530.67 | $530.67 | $1,263.53 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,263.53 | $1,263.53 | $1,263.53 | |
United
| Professional | $530.67 | $530.67 | $1,263.53 |