| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.18 | $165.96 | $223.87 | |
Cigna
| Facility | $194.98 | $194.98 | $194.98 | |
Cigna
| Professional | $26.30 | $28.84 | $43.65 | |
United
| Professional | $138.04 | $194.98 | $426.58 |
Radiologic examination, radiostereometric analysis (RSA); upper extremity(ies), (includes shoulder, elbow, and wrist, when performed)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.18 | $165.96 | $223.87 | |
Cigna
| Facility | $194.98 | $194.98 | $194.98 | |
Cigna
| Professional | $26.30 | $28.84 | $43.65 | |
United
| Professional | $138.04 | $194.98 | $426.58 |