| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.72 | $3,038.00 | $4,626.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |
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 | $85.72 | $3,038.00 | $4,626.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |