| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $277.58 | $464.56 | $1,400.00 | |
CareSource
| Facility | $310.52 | $359.76 | $391.97 | |
Cigna
| Facility | $333.52 | $333.52 | $333.52 | |
Cigna
| Facility | AS | $32.72 | $32.72 | $32.72 |
Vcrpec Lat Xtrcavitary Dcmprn Thrc/Lmbr Ea Seg
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $277.58 | $464.56 | $1,400.00 | |
CareSource
| Facility | $310.52 | $359.76 | $391.97 | |
Cigna
| Facility | $333.52 | $333.52 | $333.52 | |
Cigna
| Facility | AS | $32.72 | $32.72 | $32.72 |