| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $456.83 | $1,223.00 | $2,250.00 | |
BCBS
| Facility | $500.53 | $607.41 | $817.17 | |
United
| Facility | $625.00 | $1,768.00 | $3,360.00 |
Repair Intermediate S/A/T/E >30.0 Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $456.83 | $1,223.00 | $2,250.00 | |
BCBS
| Facility | $500.53 | $607.41 | $817.17 | |
United
| Facility | $625.00 | $1,768.00 | $3,360.00 |