| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $709.29 | $15,115.80 | $16,774.81 | |
Martin's Point
| Facility | $15,115.80 | $15,115.80 | $16,774.81 |
Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $709.29 | $15,115.80 | $16,774.81 | |
Martin's Point
| Facility | $15,115.80 | $15,115.80 | $16,774.81 |