| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,677.50 | $1,677.50 | $1,677.50 | |
United
| Facility | $29,649.00 | $29,649.00 | $38,228.00 | |
United
| Professional | $2,152.14 | $4,227.12 | $6,100.70 |
Plmt Scjncl Rta Prosth&Pls&Impltj Intra-Oc Rta
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,677.50 | $1,677.50 | $1,677.50 | |
United
| Facility | $29,649.00 | $29,649.00 | $38,228.00 | |
United
| Professional | $2,152.14 | $4,227.12 | $6,100.70 |