| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.96 | $5,109.00 | $9,860.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |
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 | $97.96 | $5,109.00 | $9,860.00 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |