| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,422.67 | $1,422.67 | $8,500.00 | |
Medica
| Facility | $1,422.67 | $1,714.15 | $4,268.01 |
Strtctc Impltj Nstim Eltrd W/O Record 1st Array
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,422.67 | $1,422.67 | $8,500.00 | |
Medica
| Facility | $1,422.67 | $1,714.15 | $4,268.01 |