| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,635.55 | $2,747.00 | $5,484.00 | |
Kaiser Permanente
| Professional | $751.87 | $820.22 | $956.93 | |
United
| Facility | $2,155.00 | $2,155.00 | $2,155.00 |
Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,635.55 | $2,747.00 | $5,484.00 | |
Kaiser Permanente
| Professional | $751.87 | $820.22 | $956.93 | |
United
| Facility | $2,155.00 | $2,155.00 | $2,155.00 |