| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $565.37 | $1,011.79 | $2,500.00 | |
Medica
| Facility | $565.37 | $1,020.13 | $1,780.02 |
Corrj Hlx Vlgs Bncty Sesmdc Prox Metar Osteot
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $565.37 | $1,011.79 | $2,500.00 | |
Medica
| Facility | $565.37 | $1,020.13 | $1,780.02 |