| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $518.00 | $1,277.00 | $9,477.00 | |
United
| Facility | $375.00 | $1,056.00 | $2,558.00 |
Dlyd Placement Xtn Prosth For Evasc Rpr Ea Addl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $518.00 | $1,277.00 | $9,477.00 | |
United
| Facility | $375.00 | $1,056.00 | $2,558.00 |