| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $210.00 | $229.00 | $318.00 |
Unlisted Procedure Therapeutic Radiology Tx Mgmt
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $210.00 | $229.00 | $318.00 |