| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $657.94 | $1,029.76 | $4,036.32 | |
CareSource
| Facility | $717.96 | $797.47 | $868.86 | |
Cigna
| Facility | $771.12 | $771.12 | $771.12 |
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 | $657.94 | $1,029.76 | $4,036.32 | |
CareSource
| Facility | $717.96 | $797.47 | $868.86 | |
Cigna
| Facility | $771.12 | $771.12 | $771.12 |