| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $700.31 | $3,057.36 | $3,301.91 | |
Martin's Point
| Facility | $700.31 | $1,528.68 | $3,301.91 |
Tr/Trnspl 1 Tdn W/Musc Redirion/Rerouting Supfc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $700.31 | $3,057.36 | $3,301.91 | |
Martin's Point
| Facility | $700.31 | $1,528.68 | $3,301.91 |