| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $300.25 | $1,040.00 | $12,339.20 | |
United
| Facility | $690.00 | $1,236.00 | $8,817.00 |
Dlyd Placement Xtn Prosth For Evasc Rpr Ea Addl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $300.25 | $1,040.00 | $12,339.20 | |
United
| Facility | $690.00 | $1,236.00 | $8,817.00 |