| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,464.00 | $6,782.00 | $14,552.94 | |
Moda Health
| Facility | $782.18 | $3,127.76 | $4,472.70 | |
Providence
| Facility | $782.18 | $3,127.76 | $4,472.70 |
Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,464.00 | $6,782.00 | $14,552.94 | |
Moda Health
| Facility | $782.18 | $3,127.76 | $4,472.70 | |
Providence
| Facility | $782.18 | $3,127.76 | $4,472.70 |