| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $522.14 | $2,737.21 | $3,832.09 | |
Providence
| Facility | $522.14 | $2,737.21 | $3,832.09 |
Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,872.00 | $8,303.41 | $13,413.92 | |
Moda Health
| Facility | $522.14 | $2,737.21 | $3,832.09 | |
Providence
| Facility | $522.14 | $2,737.21 | $3,832.09 |