| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,966.00 | $7,655.00 | $14,450.00 | |
Medica
| Facility | $1,171.47 | $2,452.56 | $26,542.00 | |
United
| Facility | $2,269.00 | $6,170.00 | $12,989.00 |
Thrmbc Artl/Ven Grf Xcp Hemo Grf/Fstl W/Revj Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,966.00 | $7,655.00 | $14,450.00 | |
Medica
| Facility | $1,171.47 | $2,452.56 | $26,542.00 | |
United
| Facility | $2,269.00 | $6,170.00 | $12,989.00 |