| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,702.74 | $5,702.74 | $44,565.43 | |
Martin's Point
| Facility | $5,702.74 | $5,702.74 | $44,565.43 |
Ins/Rplcmnt Perm Subq Impltbl Dfb W/Subq Eltrd
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,702.74 | $5,702.74 | $44,565.43 | |
Martin's Point
| Facility | $5,702.74 | $5,702.74 | $44,565.43 |