| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $434.48 | $3,575.00 | $4,601.00 | |
Kaiser Permanente
| Professional | $429.58 | $967.97 | $967.97 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |
Repair Intermediate N/H/F/Xtrnl Gent 12.6-20 Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $434.48 | $3,575.00 | $4,601.00 | |
Kaiser Permanente
| Professional | $429.58 | $967.97 | $967.97 | |
United
| Facility | $165.00 | $442.00 | $5,940.00 |