| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,761.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $634.83 | $634.83 | $634.83 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |
Dlyd Placement Xtn Prosth For Evasc Rpr Ea Addl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.00 | $2,761.00 | $4,100.00 | |
Kaiser Permanente
| Professional | $634.83 | $634.83 | $634.83 | |
United
| Facility | $645.00 | $1,319.00 | $16,382.00 |