| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,263.19 | $9,577.00 | $14,552.94 | |
Moda Health
| Facility | $1,219.86 | $5,534.50 | $9,383.77 | |
Providence
| Facility | $1,291.72 | $5,697.29 | $9,383.77 |
Capsul Midfoot W/Pst Talotibl Capsul&Tdn Lngth
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,263.19 | $9,577.00 | $14,552.94 | |
Moda Health
| Facility | $1,219.86 | $5,534.50 | $9,383.77 | |
Providence
| Facility | $1,291.72 | $5,697.29 | $9,383.77 |