| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $773.38 | $773.38 | $990.47 |
Simple Repair F/E/E/N/L/M 7.6cm-12.5 Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $773.38 | $773.38 | $990.47 |