| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,222.79 | $2,393.07 | $4,420.33 | |
United
| Facility | $375.00 | $1,056.00 | $2,558.00 |
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| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,222.79 | $2,393.07 | $4,420.33 | |
United
| Facility | $375.00 | $1,056.00 | $2,558.00 |