| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,995.26 | $10,000.00 | $16,982.44 | |
Moda Health
| Facility | $602.56 | $1,047.13 | $4,570.88 | |
Providence
| Facility | $630.96 | $1,023.29 | $3,630.78 |
Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,995.26 | $10,000.00 | $16,982.44 | |
Moda Health
| Facility | $602.56 | $1,047.13 | $4,570.88 | |
Providence
| Facility | $630.96 | $1,023.29 | $3,630.78 |