| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $848.96 | $848.96 | $8,500.00 | |
Medica
| Facility | $848.96 | $1,163.16 | $2,546.88 |
Rmvl1/Dual Chmbr Impltbl Dfb Eltrd Transvns Xtrj
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $848.96 | $848.96 | $8,500.00 | |
Medica
| Facility | $848.96 | $1,163.16 | $2,546.88 |