| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,277.00 | $2,604.19 | $4,752.89 | |
United
| Facility | $375.00 | $1,056.00 | $2,558.00 |
Rescj/Exc Les Infratempor Fossa Space Apex Xdrl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,277.00 | $2,604.19 | $4,752.89 | |
United
| Facility | $375.00 | $1,056.00 | $2,558.00 |