| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $654.53 | $654.53 | $8,500.00 | |
Medica
| Facility | $654.53 | $925.60 | $1,112.70 | |
United
| Facility | $13,859.81 | $13,859.81 | $13,859.81 |
Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $654.53 | $654.53 | $8,500.00 | |
Medica
| Facility | $654.53 | $925.60 | $1,112.70 | |
United
| Facility | $13,859.81 | $13,859.81 | $13,859.81 |