| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $311.32 | $311.32 | $1,400.00 | |
CareSource
| Facility | $309.62 | $358.21 | $390.29 | |
Cigna
| Facility | $332.16 | $332.16 | $332.16 |
Dlyd Placement Xtn Prosth For Evasc Rpr Ea Addl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $311.32 | $311.32 | $1,400.00 | |
CareSource
| Facility | $309.62 | $358.21 | $390.29 | |
Cigna
| Facility | $332.16 | $332.16 | $332.16 |