| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $45.36 | $45.37 | $45.37 |
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 | $45.36 | $45.37 | $45.37 |