| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.66 | $5,640.00 | $5,640.00 | |
CareSource
| Facility | $80.58 | $90.79 | $98.91 | |
Cigna
| Facility | $129.19 | $129.19 | $129.19 |
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 | $73.66 | $5,640.00 | $5,640.00 | |
CareSource
| Facility | $80.58 | $90.79 | $98.91 | |
Cigna
| Facility | $129.19 | $129.19 | $129.19 |