| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.01 | $431.78 | $8,005.65 |
Split Agrft T/A/L Ea 100 Cm/Ea 1% Bdy Inft/Chld
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.01 | $431.78 | $8,005.65 |