| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $312.43 | $312.43 | $312.43 | |
Martin's Point
| Facility | $312.43 | $312.43 | $312.43 |
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $312.43 | $312.43 | $312.43 | |
Martin's Point
| Facility | $312.43 | $312.43 | $312.43 |