| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $889.04 | $889.04 | $8,500.00 | |
Medica
| Facility | $889.04 | $1,088.46 | $1,511.37 |
Exc Sac Pr Ulc Prepj Musc/Myoq Flap/Skn Grf Clsr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $889.04 | $889.04 | $8,500.00 | |
Medica
| Facility | $889.04 | $1,088.46 | $1,511.37 |