| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.37 | $2,910.00 | $4,387.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |
Epidrm 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 | $112.37 | $2,910.00 | $4,387.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |