| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.66 | $121.66 | $8,500.00 | |
Medica
| Facility | $121.66 | $154.79 | $364.98 |
Exclusion Laa Open Tm Strnt/Thrcm Any Method
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.66 | $121.66 | $8,500.00 | |
Medica
| Facility | $121.66 | $154.79 | $364.98 |