| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $354.87 | $855.84 | $855.84 |
Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $354.87 | $855.84 | $855.84 |