| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $402.99 | $402.99 | $8,500.00 | |
Medica
| Facility | $402.99 | $575.83 | $727.22 |
Arthrt Wrst W/Jt Expl W/Wo Bx W/Wo Rmvl Loose/Fb
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $402.99 | $402.99 | $8,500.00 | |
Medica
| Facility | $402.99 | $575.83 | $727.22 |