| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $933.23 | $978.23 | $1,290.58 |
Opn Subcla Crtd Art Trpos Nck Inc Ulat
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $933.23 | $978.23 | $1,290.58 |