| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.00 | $214.00 | $214.00 | |
Ambetter
| Facility | $190.00 | $194.78 | $244.06 |
Radiology-Diagnostic Other
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.00 | $214.00 | $214.00 | |
Ambetter
| Facility | $190.00 | $194.78 | $244.06 |