| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,816.00 | $5,816.00 | $6,907.00 |
Exc Sac Pr Ulc Prepj Musc/Myoq Flap/Skn Grf Ostc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,816.00 | $5,816.00 | $6,907.00 |