| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $680.06 | $680.06 | $1,060.00 |
Martin's Point
| Facility | 54 | $680.06 | $680.06 | $1,060.00 |
Closed treatment of patellar dislocation; without anesthesia
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $680.06 | $680.06 | $1,060.00 |
Martin's Point
| Facility | 54 | $680.06 | $680.06 | $1,060.00 |