| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,424.15 | $3,243.94 | $3,955.04 | |
United
| Facility | $540.00 | $1,401.00 | $4,915.00 |
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 | $2,424.15 | $3,243.94 | $3,955.04 | |
United
| Facility | $540.00 | $1,401.00 | $4,915.00 |