| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,816.00 | $5,816.00 | $6,907.00 |
Revj Fem Anast Bpg Grn Opn W/Nonautog Patch Grf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,816.00 | $5,816.00 | $6,907.00 |