| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $215.25 | $325.81 | $24,944.19 | |
Martin's Point
| Facility | $24,944.19 | $24,944.19 | $24,944.19 |
Repair Intermediate N/H/F/Xtrnl Gent 12.6-20 Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $215.25 | $325.81 | $24,944.19 | |
Martin's Point
| Facility | $24,944.19 | $24,944.19 | $24,944.19 |