| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $663.00 | $808.00 | $900.00 | |
Anthem BCBS
| Facility | $329.00 | $642.00 | $772.00 |
Other Therapeutic Services (see also 095X, an extension of 094X)-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $663.00 | $808.00 | $900.00 | |
Anthem BCBS
| Facility | $329.00 | $642.00 | $772.00 |