| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $685.15 | $685.15 | $8,500.00 | |
Medica
| Facility | $685.15 | $951.84 | $2,055.44 |
Rmvl I-Aort Balo Asst Dev W/Rpr Fem Art W/Wo Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $685.15 | $685.15 | $8,500.00 | |
Medica
| Facility | $685.15 | $951.84 | $2,055.44 |