| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $157.38 | $157.38 | $157.38 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 |
Unspecified Adjunctive Procedure, By Report
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $157.38 | $157.38 | $157.38 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 |