| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,001.13 | $1,100.15 | $1,695.27 | |
United
| Facility | $819.00 | $819.00 | $819.00 |
Opn Subcla Crtd Art Trpos Nck Inc Ulat
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,001.13 | $1,100.15 | $1,695.27 | |
United
| Facility | $819.00 | $819.00 | $819.00 |