| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.45 | $3,294.00 | $7,568.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |
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 | $181.45 | $3,294.00 | $7,568.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |