| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.10 | $42.10 | $42.10 | |
Aetna
| Professional | $42.10 | $42.10 | $76.06 | |
United
| Professional | $60.92 | $77.20 | $125.72 |
Noncontact R-T Fluor Wnd Img Ea Addl Antmc Site
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.10 | $42.10 | $42.10 | |
Aetna
| Professional | $42.10 | $42.10 | $76.06 | |
United
| Professional | $60.92 | $77.20 | $125.72 |