| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $523.13 | $523.13 | $523.13 |
Martin's Point
| Facility | 54 | $523.13 | $523.13 | $523.13 |
Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $523.13 | $523.13 | $523.13 |
Martin's Point
| Facility | 54 | $523.13 | $523.13 | $523.13 |