| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $289.49 | $289.49 | $289.49 |
Anes Rpr Ruptured Achilles Tendon W/Wo Graft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $289.49 | $289.49 | $289.49 |