| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,439.64 | $1,439.64 | $9,500.00 | |
Medica
| Facility | $1,439.64 | $1,910.94 | $2,484.98 |
Optx&/Rdctj Vrt Fx&/Dislc Pst 1 Vrt Sgm Cr
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,439.64 | $1,439.64 | $9,500.00 | |
Medica
| Facility | $1,439.64 | $1,910.94 | $2,484.98 |