| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,434.69 | $2,434.69 | $2,434.69 | |
Kaiser Permanente
| Professional | $204.63 | $275.83 | $499.80 | |
United
| Facility | $150.00 | $150.00 | $150.00 |
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 | $2,434.69 | $2,434.69 | $2,434.69 | |
Kaiser Permanente
| Professional | $204.63 | $275.83 | $499.80 | |
United
| Facility | $150.00 | $150.00 | $150.00 |