| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,486.63 | $9,813.00 | $18,488.32 | |
Moda Health
| Facility | $708.21 | $3,589.31 | $5,132.71 | |
Providence
| Facility | $708.21 | $3,589.31 | $5,025.03 |
Optx Dstl Radl X-Artic Fx/Epiphysl Sep
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,486.63 | $9,813.00 | $18,488.32 | |
Moda Health
| Facility | $708.21 | $3,589.31 | $5,132.71 | |
Providence
| Facility | $708.21 | $3,589.31 | $5,025.03 |