| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $139.03 | $5,975.00 | $10,692.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |
Split Agrft T/A/L Ea 100 Cm/Ea 1% Bdy Inft/Chld
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $139.03 | $5,975.00 | $10,692.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |