| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $228.00 | $950.00 | $1,831.00 | |
United
| Facility | $216.00 | $485.00 | $1,888.00 |
Bx Lvr Ndl Done Purpose Tm Oth Major Px
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $228.00 | $950.00 | $1,831.00 | |
United
| Facility | $216.00 | $485.00 | $1,888.00 |