| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $215.36 | $215.36 | $215.36 |
Lam Facetec/Foramot Drg Arthrd Lmbr Ea Addl Sgm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $215.36 | $215.36 | $215.36 |