| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $29.12 | $29.12 | $29.12 |
Kaiser Permanente
| Professional | 26 | $32.72 | $40.70 | $70.70 |
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 | $29.12 | $29.12 | $29.12 |
Kaiser Permanente
| Professional | 26 | $32.72 | $40.70 | $70.70 |