| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $66.65 | $87.15 | $156.93 |
Cigna
| Facility | 26 | $78.06 | $78.06 | $78.06 |
Card Bl Pool Plnr Mlt Stdy Wal Motn Eject Fract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $66.65 | $87.15 | $156.93 |
Cigna
| Facility | 26 | $78.06 | $78.06 | $78.06 |
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