| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $939.40 | $3,057.36 | $5,771.92 | |
Martin's Point
| Facility | $3,057.36 | $3,057.36 | $5,771.92 |
Rcnstj Dislc Patella W/Xtnsr Relignmt&/Musc Rl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $939.40 | $3,057.36 | $5,771.92 | |
Martin's Point
| Facility | $3,057.36 | $3,057.36 | $5,771.92 |