| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.78 | $690.78 | $8,500.00 | |
Medica
| Facility | $690.78 | $891.31 | $1,174.33 |
Dbrdmt Skn Subq T/M/F Necro Infctj Gent Per&Abdl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.78 | $690.78 | $8,500.00 | |
Medica
| Facility | $690.78 | $891.31 | $1,174.33 |