| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $175.91 | $844.00 | $2,010.00 | |
United
| Facility | $225.00 | $513.00 | $1,581.00 |
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 | $175.91 | $844.00 | $2,010.00 | |
United
| Facility | $225.00 | $513.00 | $1,581.00 |