| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,736.00 | $4,736.00 | $6,907.00 | |
United
| Facility | $143.00 | $143.00 | $143.00 |
Prtl Exc Pst Vrt Intrnsc B1y Les 1 Vrt Sgm Ea
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,736.00 | $4,736.00 | $6,907.00 | |
United
| Facility | $143.00 | $143.00 | $143.00 |