| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $955.00 | $2,035.00 | $4,738.00 | |
Lucent Health
| Facility | $1,600.00 | $2,071.00 | $4,000.00 | |
Providence
| Facility | $14,957.00 | $14,957.00 | $15,555.00 |
Loa/Reserved
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $955.00 | $2,035.00 | $4,738.00 | |
Lucent Health
| Facility | $1,600.00 | $2,071.00 | $4,000.00 | |
Providence
| Facility | $14,957.00 | $14,957.00 | $15,555.00 |