| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.93 | $2,145.78 | $7,838.38 | |
Providence
| Facility | $88.97 | $125.60 | $171.48 | |
United
| Facility | $230.00 | $1,158.00 | $1,401.00 |
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 | $113.93 | $2,145.78 | $7,838.38 | |
Providence
| Facility | $88.97 | $125.60 | $171.48 | |
United
| Facility | $230.00 | $1,158.00 | $1,401.00 |