| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,452.88 | $1,452.88 | $9,500.00 | |
Aetna
| Facility | 52 | $726.44 | $726.44 | $726.44 |
Medica
| Facility | $1,452.88 | $1,976.60 | $2,657.13 |
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 | $1,452.88 | $1,452.88 | $9,500.00 | |
Aetna
| Facility | 52 | $726.44 | $726.44 | $726.44 |
Medica
| Facility | $1,452.88 | $1,976.60 | $2,657.13 |