| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $723.55 | $723.55 | $8,500.00 | |
Medica
| Facility | $723.55 | $935.81 | $1,261.03 |
Rcnstj Coltrl Ligm Iphal Jt 1 W/Grf Ea Jt
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $723.55 | $723.55 | $8,500.00 | |
Medica
| Facility | $723.55 | $935.81 | $1,261.03 |