| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,209.39 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $1,343.07 | $6,164.29 | $8,814.93 | |
Providence
| Facility | $1,343.07 | $6,164.29 | $8,814.93 |
Plmt Prox Xtn Prosth Evasc Rpr Dta 1st Xtn
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,209.39 | $10,900.00 | $14,552.94 | |
Moda Health
| Facility | $1,343.07 | $6,164.29 | $8,814.93 | |
Providence
| Facility | $1,343.07 | $6,164.29 | $8,814.93 |