| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $433.67 | $433.67 | $433.67 |
Card Bl Pool Plnr Mlt Stdy Wal Motn Eject Fract
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $433.67 | $433.67 | $433.67 |