| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.43 | $2,910.00 | $4,387.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |
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 | $96.43 | $2,910.00 | $4,387.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |