| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $400.00 | $1,300.00 | $3,500.00 | |
United
| Facility | $385.00 | $1,309.00 | $7,168.00 |
Dlyd Placement Xtn Prosth For Evasc Rpr Ea Addl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $400.00 | $1,300.00 | $3,500.00 | |
United
| Facility | $385.00 | $1,309.00 | $7,168.00 |