| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $332.39 | $362.18 | $916.11 |
Health Alliance Plan
| Facility | 54 | $332.39 | $916.11 | $916.11 |
Closed Tx Patellar Dislocation W/O Anesthesia
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 54 | $332.39 | $362.18 | $916.11 |
Health Alliance Plan
| Facility | 54 | $332.39 | $916.11 | $916.11 |