| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,140.00 | $3,140.00 | $6,907.00 | |
Highmark BCBS
| Facility | $222.66 | $222.66 | $222.66 |
Simple Repair F/E/E/N/L/M 7.6cm-12.5 Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,140.00 | $3,140.00 | $6,907.00 | |
Highmark BCBS
| Facility | $222.66 | $222.66 | $222.66 |