| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $345.68 | $345.68 | $345.68 | |
United
| Professional | $457.20 | $482.72 | $3,863.43 |
Removal&Rplcmt Pg Wcs Lv Pacg Both Components
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $345.68 | $345.68 | $345.68 | |
United
| Professional | $457.20 | $482.72 | $3,863.43 |