| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.08 | $316.08 | $1,400.00 | |
CareSource
| Facility | $312.89 | $361.86 | $394.25 | |
Cigna
| Facility | $336.74 | $336.74 | $336.74 |
Opn Ax/Subcla Art Expos Dlvr Evasc Prosth Uni
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.08 | $316.08 | $1,400.00 | |
CareSource
| Facility | $312.89 | $361.86 | $394.25 | |
Cigna
| Facility | $336.74 | $336.74 | $336.74 |