| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $731.64 | $3,290.94 | $10,199.37 | |
Medica
| Facility | $731.64 | $1,243.79 | $6,940.50 |
Optx Dstl Radl X-Artic Fx/Epiphysl Sep
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $731.64 | $3,290.94 | $10,199.37 | |
Medica
| Facility | $731.64 | $1,243.79 | $6,940.50 |