| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,047.13 | $1,047.13 | $1,047.13 | |
United
| Facility | $60,255.96 | $63,095.73 | $66,069.34 |
Loa - Reserved
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,047.13 | $1,047.13 | $1,047.13 | |
United
| Facility | $60,255.96 | $63,095.73 | $66,069.34 |
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