| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $280.55 | $4,376.00 | $12,600.00 | |
Cigna
| Facility | $505.00 | $505.00 | $505.00 | |
Medica
| Facility | $133.53 | $280.55 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |
Split Agrft F/S/N/H/F/G/M/D Gt Ea 100 Cm/Ea 1 %
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $280.55 | $4,376.00 | $12,600.00 | |
Cigna
| Facility | $505.00 | $505.00 | $505.00 | |
Medica
| Facility | $133.53 | $280.55 | $2,819.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |