| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,610.66 | $1,610.66 | $8,500.00 | |
Medica
| Facility | $1,610.66 | $2,172.46 | $4,831.97 |
Byp Fem-Ant Tibl Pst Tibl Proneal Art/Oth Dstl
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,610.66 | $1,610.66 | $8,500.00 | |
Medica
| Facility | $1,610.66 | $2,172.46 | $4,831.97 |