| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $458.11 | $475.73 | $516.36 |
Health Alliance Plan
| Facility | 54 | $458.11 | $458.11 | $497.24 |
Closed treatment of knee dislocation; without anesthesia
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $458.11 | $475.73 | $516.36 |
Health Alliance Plan
| Facility | 54 | $458.11 | $458.11 | $497.24 |