| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.32 | $143.74 | $2,000.00 | |
Medica
| Facility | $90.32 | $149.83 | $244.36 |
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.32 | $143.74 | $2,000.00 | |
Medica
| Facility | $90.32 | $149.83 | $244.36 |