| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.96 | $44.37 | $77.67 |
Cigna
| Facility | 26 | $38.68 | $38.68 | $38.68 |
Rp Loclzj Tum Plnr 2+Area 1+D Img/1 Area Img>2+D
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $32.96 | $44.37 | $77.67 |
Cigna
| Facility | 26 | $38.68 | $38.68 | $38.68 |
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