| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.87 | $104.87 | $104.87 | |
Aetna
| Professional | $144.00 | $144.00 | $144.00 | |
Cigna
| Professional | $59.25 | $59.25 | $59.25 |
Unlisted diagnostic radiographic procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.87 | $104.87 | $104.87 | |
Aetna
| Professional | $144.00 | $144.00 | $144.00 | |
Cigna
| Professional | $59.25 | $59.25 | $59.25 |