| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $208.32 | $1,223.00 | $2,250.00 | |
BCBS
| Facility | $248.85 | $301.99 | $406.27 | |
United
| Facility | $241.00 | $850.00 | $1,349.00 |
Simple Repair F/E/E/N/L/M 12.6cm-20.0 Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $208.32 | $1,223.00 | $2,250.00 | |
BCBS
| Facility | $248.85 | $301.99 | $406.27 | |
United
| Facility | $241.00 | $850.00 | $1,349.00 |