| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $3,999.00 | $6,456.00 | |
Kaiser Permanente
| Professional | $917.60 | $1,907.30 | $1,907.30 | |
United
| Facility | $3,279.00 | $9,894.00 | $26,408.00 |
Sutr Infrapatellar Tdn 2 Rcnstj W/Fscal/Tdn Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $3,999.00 | $6,456.00 | |
Kaiser Permanente
| Professional | $917.60 | $1,907.30 | $1,907.30 | |
United
| Facility | $3,279.00 | $9,894.00 | $26,408.00 |