| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.25 | $4,294.00 | $9,950.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |
Prep Site F/S/N/H/F/G/M/D Gt Addl 100 Sq Cm/1pct
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.25 | $4,294.00 | $9,950.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |