| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $456.72 | $456.72 | $456.72 | |
Martin's Point
| Facility | $456.72 | $456.72 | $456.72 |
Unlistd Px Med Radj Physic Dosim&Tx Dev&Spec Svc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $456.72 | $456.72 | $456.72 | |
Martin's Point
| Facility | $456.72 | $456.72 | $456.72 |