| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $670.49 | $670.49 | $670.49 |
Martin's Point
| Facility | 54 | $670.49 | $670.49 | $670.49 |
Closed Tx Knee Dislocation W/O Anesthesia
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $670.49 | $670.49 | $670.49 |
Martin's Point
| Facility | 54 | $670.49 | $670.49 | $670.49 |