| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.17 | $29.17 | $29.17 | |
Aetna
| Professional | $29.17 | $53.95 | $129.02 | |
BCBS
| Facility | $262.61 | $262.61 | $262.61 | |
United
| Professional | $36.81 | $175.83 | $283.97 |
Dev Interr Prgrmg Io Rta Eltrd Ra W/Adj & Reprt
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.17 | $29.17 | $29.17 | |
Aetna
| Professional | $29.17 | $53.95 | $129.02 | |
BCBS
| Facility | $262.61 | $262.61 | $262.61 | |
United
| Professional | $36.81 | $175.83 | $283.97 |