| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $402.40 | $402.40 | $455.22 | |
Martin's Point
| Facility | $402.40 | $402.40 | $455.22 |
Plmt Sft Tiss Loclzj Dev Perq Each Addl Lesion
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $402.40 | $402.40 | $455.22 | |
Martin's Point
| Facility | $402.40 | $402.40 | $455.22 |