| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.00 | $153.00 | $153.00 | |
Aetna
| Professional | $153.00 | $153.00 | $153.00 | |
Cigna
| Facility | $438.43 | $666.69 | $962.72 |
Rp Therapy Unlisted Procedure
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.00 | $153.00 | $153.00 | |
Aetna
| Professional | $153.00 | $153.00 | $153.00 | |
Cigna
| Facility | $438.43 | $666.69 | $962.72 |