| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $917.80 | $917.80 | $8,500.00 | |
Medica
| Facility | $917.80 | $1,249.36 | $2,753.40 |
Emblc/Thrmbc Popliteal-Tibio-Proneal Art Leg Inc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $917.80 | $917.80 | $8,500.00 | |
Medica
| Facility | $917.80 | $1,249.36 | $2,753.40 |