| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $221.74 | $221.74 | $221.74 |
Medcost
| Facility | 26 | $319.00 | $406.00 | $776.53 |
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $221.74 | $221.74 | $221.74 |
Medcost
| Facility | 26 | $319.00 | $406.00 | $776.53 |