| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $399.56 | $399.56 | $8,500.00 | |
Medica
| Facility | $399.56 | $561.00 | $679.25 |
Dcmprn Fasct Leg Ant&/Lat Compartments Only
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $399.56 | $399.56 | $8,500.00 | |
Medica
| Facility | $399.56 | $561.00 | $679.25 |