| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16,595.87 | $16,595.87 | $16,595.87 | |
Martin's Point
| Facility | $16,595.87 | $16,595.87 | $16,595.87 |
Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16,595.87 | $16,595.87 | $16,595.87 | |
Martin's Point
| Facility | $16,595.87 | $16,595.87 | $16,595.87 |