| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.00 | $137.00 | $1,400.00 | |
CareSource
| Facility | $136.24 | $156.78 | $170.82 | |
Cigna
| Facility | $145.90 | $145.90 | $145.90 | |
Cigna
| Facility | AS | $14.13 | $14.13 | $14.13 |
Exclusion Laa Open Tm Strnt/Thrcm Any Method
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.00 | $137.00 | $1,400.00 | |
CareSource
| Facility | $136.24 | $156.78 | $170.82 | |
Cigna
| Facility | $145.90 | $145.90 | $145.90 | |
Cigna
| Facility | AS | $14.13 | $14.13 | $14.13 |