| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,029.09 | $7,838.38 | $8,942.39 | |
Providence
| Facility | $1,061.26 | $1,481.34 | $1,506.35 | |
United
| Facility | $9,028.00 | $15,131.00 | $16,269.00 |
Thrmbc Artl/Ven Grf Xcp Hemo Grf/Fstl W/Revj Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,029.09 | $7,838.38 | $8,942.39 | |
Providence
| Facility | $1,061.26 | $1,481.34 | $1,506.35 | |
United
| Facility | $9,028.00 | $15,131.00 | $16,269.00 |