| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.35 | $900.00 | $1,831.00 | |
United
| Facility | $225.00 | $513.00 | $1,581.00 |
Fth/Gft Fr W/Dir Clsr Trnk Ea Addl 20 Sq Cm
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.35 | $900.00 | $1,831.00 | |
United
| Facility | $225.00 | $513.00 | $1,581.00 |