| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $488.56 | $677.31 | $5,000.00 | |
Medica
| Facility | $488.56 | $799.00 | $1,151.43 |
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| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $488.56 | $677.31 | $5,000.00 | |
Medica
| Facility | $488.56 | $799.00 | $1,151.43 |