| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $617.12 | $2,796.19 | $2,796.19 | |
CareSource
| Facility | $426.00 | $477.91 | $520.70 | |
Cigna
| Facility | $453.89 | $453.89 | $453.89 |
Dcmprn Fasct Leg Ant&/Lat Compartments Only
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $617.12 | $2,796.19 | $2,796.19 | |
CareSource
| Facility | $426.00 | $477.91 | $520.70 | |
Cigna
| Facility | $453.89 | $453.89 | $453.89 |