| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.49 | $50.49 | $55.53 |
Unlisted Therapeutic Proph/Dx Iv/Ia Njx/Nfs
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.49 | $50.49 | $55.53 |